Using machine learning to evaluate the value of genetic liabilities in classification of hypertension within the UK Biobank

Background and objective Hypertension increases the risk of cardiovascular diseases (CVD) such as stroke, heart attack, heart failure, and kidney disease, contributing to global disease burden and premature mortality. Previous studies have utilized statistical and machine learning techniques to develop hypertension prediction models. Only a few have included genetic liabilities and evaluated their predictive values. This study aimed to develop an effective hypertension prediction model and investigate the potential influence of genetic liability for risk factors linked to CVD on hypertension risk using Random Forest (RF) and Neural Network (NN). Materials and methods The study included 244,718 participants of European ancestry. Genetic liabilities were constructed using previously identified genetic variants associated with various cardiovascular risk factors through genome-wide association studies (GWAS). The sample was randomly split into training and testing sets at a 70:30 ratio. We used RF and NN techniques to develop prediction models in the training set with or without feature selection. We evaluated the models’ discrimination performance using the area under the curve (AUC), calibration, and net reclassification improvement in the testing set. Results The models without genetic liabilities achieved AUCs of 0.70 and 0.72 using RF and NN methods, respectively. Adding genetic liabilities resulted in a modest improvement in the AUC for RF but not for NN. The best prediction model was achieved using RF (AUC =0.71, Spiegelhalter z score= 0.10, P-value= 0.92, calibration slope=0.99) constructed in stage two. Conclusion Incorporating genetic factors in the model may provide a modest incremental value for hypertension prediction beyond baseline characteristics. Our study highlighted the importance of genetic liabilities for both total cholesterol and LDL within the same prediction model adds value to the classification of hypertension.