A 1 mV higher sum of ECG voltages at baseline predicted increased all-cause mortality (HR 1.10), cardiovascular mortality (HR 1.15), strokes (HR 1.21), and cardiac events (HR 1.18) (P<=0.01 for all).
RCT
double-blind
randomized
Yes
Do baseline electrocardiographic voltages and their serial changes predict mortality and cardiovascular events in elderly patients with systolic hypertension?
Baseline electrocardiographic voltages and their serial changes are independent predictors of mortality and cardiovascular events in elderly patients with isolated systolic hypertension.
Hazard Ratio: 1.1
p-value: p=<=0.01
The aim of the present study was to assess the prognostic value of ECG voltages at baseline and their serial changes during follow-up in a large prospective study with standardized follow-up and strictly defined end points. Patients who were 60 years old or older, with systolic blood pressure of 160 to 219 mm Hg and diastolic pressure <95 mm Hg, were randomized into the double-blind placebo-controlled Systolic Hypertension in Europe trial. Active treatment consisted of nitrendipine, which could be combined with or replaced by enalapril, hydrochlorothiazide, or both. At the end of the double-blind part of the trial (median follow-up, 2.0 years), follow-up was extended and all patients received active study drugs (median total follow-up, 6.1 years). Electrocardiography was performed at baseline and yearly thereafter. Electrocardiographic left ventricular mass was prospectively defined as the sum of 3 voltages (RaVL+SV1+RV5), which averaged 3.1+/-1.0 mV. The adjusted relative hazard rate, associated with a 1 mV higher sum at baseline, amounted to 1.10 and 1.15 for all-cause and cardiovascular mortality and to 1.21 and 1.18 for strokes and cardiac events, respectively (P< or =0.01 for all). A 1-mV decrease in electrocardiographic voltages during follow-up independently predicted a lower incidence of cardiac events (relative hazard rate: 0.86; P< or =0.05), but not of stroke or mortality. In conclusion, electrocardiographic voltages at baseline and their serial changes during follow-up predict subsequent events in older patients with systolic hypertension.
Fagard et al. (Tue,) conducted a rct in systolic hypertension. 1 mV higher sum of ECG voltages at baseline was evaluated on all-cause mortality (HR 1.10, p=<=0.01). A 1 mV higher sum of ECG voltages at baseline predicted increased all-cause mortality (HR 1.10), cardiovascular mortality (HR 1.15), strokes (HR 1.21), and cardiac events (HR 1.18) (P<=0.01 for all).
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