Background. Hypertension is an important risk factor of cardiovascular (CV) disease. An early diagnosis of target organ damage could prevent major CV events. Electrocardiography (ECG) is a valuable clinical technique, with wide availability and high specificity, used in evaluation of hypertensive patients. However, the use of ECG as a predictor tool is controversial given its low sensitivity. This study aims to characterise ECG features in a hypertensive population and identify ECG abnormalities that could predict CV events. Methods. We studied 175 hypertensive patients without previous CV events during a follow-up mean of 4.0 ± 2.20 years. ECGs and pulse wave velocity were performed in all patients. Clinical characteristics and ECG abnormalities were evaluated and compared between the patients as they presented CV events. Results. Considering the 175 patients (53.14% male), the median age was 62 years. Median systolic blood pressure was 140 mmHg and diastolic blood pressure was 78 mmHg. Median PWV was 9.8 m/s. Of the patients, 39.4% were diabetic, 78.3% had hyperlipidaemia, and 16.0% had smoking habits. ECG identified left ventricular (LV) hypertrophy in 29.71% of the patients, and a LV strain pattern was present in 9.7% of the patients. Twenty-nine patients (16.57%) had a CV event. Comparative analyses showed statistical significance for the presence of a LV strain pattern in patients with CV events (). Univariate and multivariate analysis confirmed that a LV strain pattern was an independent predictor of CV event (HR 2.66, 95% IC 1.01–7.00). In the survival analysis, the Kaplan–Meier curve showed a worse prognosis for CV events in patients with a LV strain pattern (). Conclusion. ECG is a useful daily method to identify end-organ damage in hypertensive patients. In our study, we also observed that it may be a valuable tool for the prediction of CV events.

中文翻译：

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无心血管事件的高血压患者的心电图：一个有价值的预测工具？


背景。高血压是心血管（CV）疾病的重要危险因素。靶器官损伤的早期诊断可以预防重大心血管事件。心电图（ECG）是一种有价值的临床技术，具有广泛的可用性和高特异性，用于评估高血压患者。然而，由于其敏感性较低，使用心电图作为预测工具存在争议。本研究旨在描述高血压人群的心电图特征，并识别可预测心血管事件的心电图异常。方法。我们研究了 175 名既往没有心血管事件的高血压患者，平均随访时间为 4.0 ± 2.20 年。对所有患者进行心电图和脉搏波速度检查。当患者出现心血管事件时，对患者的临床特征和心电图异常进行评估和比较。结果。考虑到 175 名患者（53.14% 为男性），中位年龄为 62 岁。中位收缩压为 140 mmHg，中位舒张压为 78 mmHg。中位 PWV 为 9.8 m/s。其中，39.4%患有糖尿病，78.3%患有高脂血症，16.0%有吸烟习惯。心电图发现 29.71% 的患者存在左心室肥厚，9.7% 的患者存在左心室应变模式。 29 名患者 (16.57%) 发生了心血管事件。比较分析显示，患有 CV 事件的患者存在 LV 应变模式具有统计学意义（ ）。单变量和多变量分析证实，左心室应变模式是心血管事件的独立预测因子（HR 2.66，95% IC 1.01–7.00）。 在生存分析中，Kaplan-Meier 曲线显示，具有 LV 应变模式的患者的 CV 事件预后较差（ ）。结论。心电图是一种有用的日常方法，用于识别高血压患者的终末器官损伤。在我们的研究中，我们还观察到它可能是预测心血管事件的一个有价值的工具。