Study design

The UK Biobank is a large-scale biomedical database and research resource containing in-depth genetic and health information. It comprises a large, long-term (since 2006) data set from the United Kingdom, recruiting >500,000 participants from the general population; the design and participant population are described in.³¹ Data were collected through a combination of questionnaires, interviews, and blood, urine, and saliva samples and describes these physical measurements, together with lifestyle, medical history, and a series of health risk factors. The clinical characteristics of these diverse patient cohorts are summarized in Table 1.

Patient Characteristics (N = 375,145)

Values are n (%) or mean ± SD.

CVD = cardiovascular disease.

We considered 2 categories as training data for our ML model. The first consisted of traditional CVD risk factors, such as gender, age, smoking status, BMI, HT, diabetes, systolic blood pressure (SBP), and diastolic blood pressure (DBP). The second category contained data from the UK Biobank touchscreen questionnaire on psychological factors and mental health. The UK Biobank Touch Screen Questionnaire is a vital component of the assessment center process. This comprehensive questionnaire covers diverse aspects, including consent, hearing tests, and cognitive function tests. The touch screen operation involves participants responding to inquiries related to various health domains, including mental health. Participants are guided through potentially sensitive questions, such as those pertaining to nerves, anxiety, tension, or depression, as well as their history of seeing a general practitioner or psychiatrist for mental health concerns.

The study utilized data from the UK Biobank touchscreen questions, focusing on various psychological factors. These factors include mood swings, miserableness, irritability, sensitivity/hurt feelings, fed-up feelings, nervous feelings, worrier/anxious feelings, tense/highly strung, worry duration after embarrassment, suffering from nerves, loneliness/isolation, guilty feelings, risk-taking, frequency of depressed mood, unenthusiasm/disinterest, tenseness/restlessness, tiredness/lethargy, and seeking medical help for mental health issues. The study explores participants' neuroticism scores derived from twelve related questions. The data set also includes information on depression status, neuroticism, episodes of depressive symptoms, and experiences of manic/hyper episodes, providing valuable insights into the relationship between psychological factors and mental health outcomes (full data details and UK Biobank codes in Supplemental Table 1).

CVDs considered in this study included a wide selection of diagnoses: atrial fibrillation and flutter, ventricular arrhythmias, atrioventricular and left bundle-branch block, angina pectoris, acute and subsequent myocardial infarctions and subsequent complications, chronic and acute ischemic heart diseases, hypertensive heart disease, and heart failure (Supplemental Table 2).

After preprocessing to remove entries with incomplete data, the data from 375,145 subjects were analyzed using a Pearson correlation. The median diagnosis age of included patients was 58.0 years (IQR: 37-73 years). We separated the data into training and test sets with 90% and 10% of subjects.