Electrocardiographic Findings and the Development of Left Ventricular Hypertrophy Over 5 Years in Unmedicated Patients with Borderline and Mild Hypertension.

We studied electrocardiographic (ECG) and echocardiographic findings in relation to the evolution of left ventricular hypertrophy (LVH) over 5 years in 77 unmedicated men with borderline and mild hypertension. Although blood pressure did not significantly change during this period, the left ventricular mass index (LVMI) increased significantly (from 107±21 to 125±28g/m2). When LVH was defined as an LVMI>125g/m2, ECG findings indicating a diagnosis of LVH based on SV1+RV5>35mm, SV3+RaVL>28mm, sum of 12-lead QRS voltage >175mm, and Romhilt & Estes point score >4, showed predictive values of 21.1%, 50.0%, 18.9%, and 33.3%, respectively. ECG voltage changes determined by these criteria did not correlate with changes in LVMI during the observation period. These findings indicate that conventional ECG voltage criteria are inappropriate for the diagnosis of LVH or for the assessment of its progression in borderline and mild hypertension. (Hypertens Res 1994; 17: 221-225)