Hyperglycemia, Hypertension, and Hyperlipidemia Markedly Increase Cardiovascular Risk. HKU’s P-CARDIAC AI Model Enables Personalised Risk Stratification and Resource Optimised Care.
- Written by Media Outreach
HONG KONG SAR - Media OutReach Newswire - 26 October 2025 - The metabolic "Three Highs" – hyperglycemia, hypertension, and hyperlipidemia – demonstrate a strong collective impact on cardiovascular diseases. An interim report from the HEARTWISE study, led by the School of Nursing, LKS Faculty of Medicine at The University of Hong Kong (HKUMed), reveals that patients presenting with this metabolic triad face up to 70% risk of recurrent major adverse cardiovascular events within ten years. The study further establishes that different risk factor combinations yield significantly varied recurrence patterns. These findings, powered by the locally developed AI-driven P-CARDIAC risk assessment model, highlight new opportunities for precision treatment planning to reduce recurrence rates and alleviate long-term pressures on Hong Kong's healthcare system. 
Professor Celine Chui Sze-ling, Assistant Professor, School of Nursing (middle), and Dr David Lui Tak-wai (right), Specialist in Endocrinology, Diabetes & Metabolism, Clinical Assistant Professor, Department of Medicine, School of Clinical Medicine, and both from the LKS Faculty of Medicine at The University of Hong Kong (HKUMed) and Biu, patient with cardiovascular disease (left), present interim HEARTWISE findings. They encourage expanded patient participation to broaden P-CARDIAC's implementation, supporting long-term goals of enhancing cardiovascular disease management and reducing Hong Kong's healthcare burden.
High Prevalence and Clinical Complexity of the Metabolic Triad The "Three Highs" represent a substantial health burden in Hong Kong. According to 2020–2022 population health survey, 8.5%, 29.5%, and 51.9% of residents aged 15–84 are affected by hyperglycemia, hypertension, and hyperlipidemia respectively. These conditions collectively drive cardiovascular mortality, accounting for one in five deaths in Hong Kong. Stroke alone claimed over 3,000 lives in 2023, ranking as the city's fourth leading cause of death. Dr David Lui Tak-wai, Specialist in Endocrinology, Diabetes & Metabolism, Clinical Assistant Professor, Department of Medicine, School of Clinical Medicine, HKUMed, explained the underlying pathology: "The 'Three Highs' damage the vascular endothelium through distinct biological pathways, accelerating atherosclerosis, luminal narrowing, and plaque formation. This significantly increases the risk of cardiovascular events such as coronary heart disease, heart failure, and peripheral arterial disease" He further detailed specific stroke risks, "Hyperglycemia increases the risks of ischemic and hemorrhagic stroke by 2.3-fold and 1.6-fold respectively, while hyperlipidemia substantially elevates ischemic stroke risk as well." "Mitigating severe event risk requires moving beyond individual biomarker management to embrace holistic vascular protection," Dr Lui emphasised. "Current assessment relies heavily on physician experience and internationally-derived tools. A precision model built on local data and AI can transform this paradigm, enabling superior risk evaluation, tailored treatment strategies, and more effective patient communication – particularly regarding underappreciated risks such as lipid control. Biu (pseudonym), a patient living with hypertension and diabetes, was hospitalized earlier this year after experiencing sudden chest tightness. During his stay, medical professionals discovered that two of his coronary arteries were severely blocked, necessitating immediate coronary angioplasty surgery. This cardiovascular event has significantly altered Biu's lifestyle. He now relies on long-term medication and has completely transformed his daily habits. Despite these changes, he continues to grapple with anxiety and uncertainty, as his condition places him at a higher risk for further health complications. Biu believes that a risk prediction tool could serve as a valuable reference point, helping him gain clarity in planning his health goals. Such a tool would not only provide him with reassurance but also offer peace of mind to his family, whom he treasures deeply. " P-CARDIAC: Personalised Risk Stratification for Precision TreatmentProfessor Celine Chui Sze-ling, Assistant Professor, School of Nursing, HKUMed, explained that P-CARDIAC was developed using up to 13 million electronic medical records from the Hospital Authority. By analysing over 120 risk variables while incorporating individual patient characteristics, the model generates personalised risk scores specifically validated for Chinese populations. To establish clinical utility, the HKU School of Nursing launched the HEARTWISE study in 2024. In collaboration with cardiologists, endocrinologists, pharmacists, and nurses, the study enrolled patients with previous cardiovascular events from public hospitals. HEARTWISE Interim Findings: Personalised Risk Patterns Emerge1) Over 90% of cardiovascular patients presented with at least one "Three...