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April 24, 2006Archives of Internal Medicine

Prognostic Impact of Prolonged Ventricular Repolarization in Hypertension

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Why the study?

Does a prolonged QTc interval predict ischemic heart disease and cardiovascular mortality in patients with uncomplicated hypertension?

Population

2,110 white patients with initially untreated essential hypertension, mean age 49 +/- 12 years, 55% men…

Comparison

Prolonged heart rate-corrected QT interval vs Normal QTc interval

Design

Cohort

Follow-up

up to 13 years (average, 5.3 years)

Key result

In patients with uncomplicated hypertension, prolonged QTc was associated with an increased risk of coronary events (HR 1.95; 95% CI 1.12-3.42; P=0.02) and cardiovascular death.

Authors

GSGiuseppe SchillaciMPMatteo PirroTRTiziana Ronti

Discussion

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Member takes

Overview

Should not yet change practice in uncomplicated hypertension; hypothesis-generating for QTc in future risk-stratification trials.

Study Design

Type

Cohort (n=2,110)

Structured PICO

Does a prolonged QTc interval predict ischemic heart disease and cardiovascular mortality in patients with uncomplicated hypertension?

P
Population
2,110 white patients with initially untreated essential hypertension, free of prevalent cardiovascular or renal disease and baseline ECG abnormalities, followed for an average of 5.3 years.
E
Exposure
Prolonged heart rate-corrected QT interval (QTc) (≥450 milliseconds in women and ≥440 milliseconds in men)
C
Comparator
Normal QTc interval
O
Outcome
New-onset ischemic heart disease (coronary events) and cardiovascular deathhard clinical

Main Result

Hazard Ratio: 1.95 (95% CI 1.12–3.42)

p-value: p=.02

Prolonged ventricular repolarization (QTc) on a baseline ECG is an independent risk factor for ischemic heart disease and cardiovascular mortality in patients with uncomplicated essential hypertension.

Cite This Study

Schillaci et al. (2006) conducted a cohort in Uncomplicated essential hypertension (n=2,110). Prolonged QTc (≥450 ms in women and ≥440 ms in men) vs. Normal QTc was evaluated on Coronary events (HR 1.95, 95% CI 1.12-3.42, p=.02). In patients with uncomplicated hypertension, prolonged QTc was associated with an increased risk of coronary events (HR 1.95; 95% CI 1.12-3.42; P=0.02) and cardiovascular death.

synapsesocial.com/papers/6a779942de5e3adfbdf72728https://doi.org/10.1001/archinte.166.8.909
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic value of ventricular repolarization prolongation in resistant hypertension: a prospective cohort study2009 · 30 citations
  2. 2PREVALENCE AND ASSOCIATED PROGNOSIS OF ELECTROCARDIOGRAPHIC FINDINGS IN HYPERTENSIVE PATIENTS. AN ANALYSIS OF A 5-YEAR FOLLOW-UP STUDY2024
  3. 3Inter-Relationship Between Electrocardiographic Left Ventricular Hypertrophy and QT Prolongation as Predictors of Increased Risk of Mortality in the General Population2014 · 32 citations
  4. 4QT interval prolongation predicts cardiovascular mortality in an apparently healthy population.1991 · 636 citations
  5. 5Prolonged QT Interval and Reduced Heart Rate Variability in Patients with Uncomplicated Essential Hypertension2008 · 40 citations