# Development of a Sex-Specific Prevalent Hypertension Discrimination Model in Korean Adults Using Genetic Risk Scores and Clinical Biomarkers: A Cross-Sectional Study

## TL;DR

This study developed sex-specific models to predict hypertension in Korean adults by combining genetic risk scores with clinical biomarkers.

## Contribution

The novel contribution is the creation of a sex-specific hypertension discrimination model using genetic and clinical data in a Korean population.

## Key findings

- A female-specific model achieved high accuracy (AUC = 0.913) using BMI, ba-PWV, 8-epi-PGF2α, and genetic risk scores.
- The total-sample model had moderate accuracy (AUC = 0.833) with similar biomarkers and genetic risk scores.
- No stable male-specific genetic risk score model met the study's criteria.

## Abstract

Genetic and metabolic factors contribute to hypertension, yet integrated sex-specific models remain limited. In this cross-sectional study, we developed sex-specific models to discriminate prevalent hypertension discrimination by integrating genetic risk scores (GRSs) with metabolic and vascular biomarkers. From 2075 Korean adults, the final models were evaluated using model-specific complete-case datasets (total n = 775; males n = 382; females n = 397). Blood pressure-related single-nucleotide polymorphisms (SNPs) were screened using genome-wide association analyses (p < 1 × 10−5), and selected variants were used to construct weighted GRSs. Models integrating GRSs with body mass index (BMI), brachial–ankle pulse wave velocity (ba-PWV), and urinary 8-epi-prostaglandin F2α (8-epi-PGF2α) were evaluated by multivariable logistic regression and receiver operating characteristic analysis, with 1000-bootstrap internal validation. Three SNPs formed the total-sample GRS (rs13175330, rs117559502, rs62099117; adjusted odds ratio [OR] = 3.20) and three formed the female GRS (rs13175330, rs6001482, rs62099117; adjusted OR = 2.80); no stable male-specific GRS met prespecified criteria. The final discrimination models achieved an area under the curve of 0.833 in the total sample and 0.913 in females (BMI + ba-PWV + 8-epi-PGF2α + GRS), and 0.758 in males (BMI + ba-PWV + 8-epi-PGF2α). These findings support sex-aware hypertension risk characterization and warrant external and prospective validation.