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A Ioannou, N Papageorgiou, D Singer, C G Missouris, Registry report of the prevalence of ECG abnormalities and their relation to patient characteristics in an asymptomatic population, QJM: An International Journal of Medicine, Volume 111, Issue 12, December 2018, Pages 875–879, https://doi.org/10.1093/qjmed/hcy212
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Abstract
Cardiovascular disease is the leading cause of morbidity and mortality in developed countries. Many patients do not experience symptoms before a first major cardiovascular event. Resting electrocardiogram (ECG) may help identify asymptomatic individuals with a high risk of cardiovascular disease.
We sought to determine the prevalence of ECG abnormalities in an apparently symptom-free adult population within a prospective registry.
The registry consisted of 4739 consecutive apparently healthy individuals [age 62.8 ± 6.2 (SD) years; 54% female], referred by their General Practitioners between 2009 and 2013. Patient demographics, and clinical data were obtained, alongside blood tests and a resting ECG.
ECG abnormalities were present in 1509 (31.8%) subjects and were commoner with increasing age (F = 0.161, p = 0.01), systolic (F = 0.134, p = 0.01) and diastolic (F = 0.44, p = 0.01) blood pressure and waist circumference (F = 0.53, p = 0.01). Left ventricular hypertrophy (LVH) was the most common abnormality (n = 281) and was positively associated with systolic (F = 0.12, p = 0.01) and diastolic blood pressure (F = 0.99, p = 0.01) and male gender (X2 = 60.5, p < 0.01). All ECG abnormalities (except for LVH) were associated with an increasing age, while right bundle branch block (F = 0.041, p = 0.01) and atrial fibrillation (n = 29; F = 0.036, p = 0.05) were associated with the presence of diabetes mellitus (n = 211). Only left bundle branch block (n = 50) was associated with angina (F = 0.05, p = 0.01).
Unrecognized cardiac abnormalities are common in middle-aged men and women with no overt symptoms. ECG offers the potential to identify these abnormalities and provide earlier intervention and treatment, and possibly improve cardiovascular outcome.
- angina pectoris
- atrial fibrillation
- electrocardiogram
- cardiovascular diseases
- diabetes mellitus
- right bundle-branch block
- heart disease risk factors
- congenital heart defects
- left ventricular hypertrophy
- blood pressure
- blood tests
- adult
- cardiovascular system
- demography
- developed countries
- diastole
- male
- middle-aged adult
- physicians, family
- systole
- morbidity
- mortality
- left bundle-branch block
- ecg abnormal
- diastolic blood pressure
- cardiovascular event
- waist circumference