{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:15:53Z","timestamp":1778595353170,"version":"3.51.4"},"reference-count":24,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vice-Rectorate for Research of the Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Early diagnosis of hypertension (HTN) is critical, but most screening models do not simultaneously distinguish phenotypes based on systolic or diastolic patterns. We developed and temporally validated a multinomial model to predict normotension and three phenotypes of undiagnosed hypertension in Peru. Methods: We used ENDES 2017\u20132019 for development (final analytic n = 62,091) and ENDES 2021\u20132024 for temporal validation (final analytic n = 77,372), excluding 2020 due to COVID-19 disruptions. We included adults aged \u226518 years without self-reported HTN. The outcome was classified as normotension, isolated diastolic hypertension (IDH), isolated systolic hypertension (ISH), or systolic\u2013diastolic hypertension (SDH). Eight nonlaboratory predictors were used: age, BMI, sex, residential altitude, smoking, alcohol consumption, vegetable intake, and fruit intake. Results: The model achieved an AUC of 0.789 (95% CI: 0.783\u20130.795) in training and 0.776 (95% CI: 0.770\u20130.781) in temporal validation. The prevalence of undiagnosed hypertension was 11.6% in the training set and 12.6% in the validation set. At a prespecified cutoff of 0.1004, sensitivity and specificity were 79.0% and 63.2% in training and 78.7% and 60.9% in validation, respectively (NPV 95.8% and 95.2%). Decision curve and clinical impact analyses suggested a positive net benefit and plausible referral volumes across a range of thresholds. Conclusions: This model could help prioritize confirmatory blood pressure measurements in resource-limited settings.<\/jats:p>","DOI":"10.3390\/medsci14020224","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:01:18Z","timestamp":1777474878000},"page":"224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Temporal Validation of a Multinomial Prediction Model for Phenotypes of Undiagnosed Hypertension in Peru: A Population-Based Study"],"prefix":"10.3390","volume":"14","author":[{"given":"V\u00edctor Juan","family":"Vera-Ponce","sequence":"first","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7070-7434","authenticated-orcid":false,"given":"Jhosmer","family":"Ballena-Caicedo","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly Estrella","family":"Delgado-Toro","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2354-273X","authenticated-orcid":false,"given":"Fiorella E.","family":"Zuzunaga-Montoya","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio C\u00e9sar","family":"Bautista Zuta","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Peru"},{"name":"Hospital Regional Virgen de F\u00e1tima, Chachapoyas 01001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossmery Leonor","family":"Poemape Mestanza","sequence":"additional","affiliation":[{"name":"Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodr\u00edguez de Mendoza de Amazonas (UNTRM), Chachapoyas 01001, Peru"},{"name":"Hospital Regional Virgen de F\u00e1tima, Chachapoyas 01001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","unstructured":"NCD Risk Factor Collaboration (NCD-RisC) (2021). 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