Morbilidad y mortalidad cardiovascular y criterios electrocardiográficos de hipertrofia ventricular izquierda en pacientes hipertensos en atención primaria

Abstract

Fundamentals and objective Electrocardiographic voltage criteria are the preferred method for diagnosis of left ventricular hypertrophy (LVH) in Primary Health Care (PHC). Several of these have been described as major adverse cardiovascular events (MACE) predictors. The aim of this study was to analyse the relationship between MACE occurrence in a cohort of hypertensive subjects in PHC and different electrocardiographic criteria recorded. Patients and methods 265 hypertensive subjects attending PHC were randomly selected and followed up for 12 years. Standard 12-lead electrocardiograms were recorded at the beginning of the study. The occurrence of ischemic heart disease, heart failure, stroke, peripheral vascular disease, arrhythmia or cardiovascular death was considered as MACE. Electrocardiographic voltage criteria recorded were: Sokolow-Lyon, Minnesota code 3.1, Gubner and Ungerleider, Cornell voltage and Schillaci and Dalfó modifications. Data were analyzed using the life-table method and Cox regression models. Results 14,3% of patients lost to follow-up showed no differences in baseline characteristics from the rest of the cohort. The median follow-up was 10.1 years (IQR: 5.8–12.0). The cumulative survival rate was 53.5% (95% CI, 45.7–61.3%). The incidence of MACE was 5.85 (95% CI, 4.73–6.97) per 100 hypertensive patients-year. In the multivariate analysis none of the ECG criteria showed statistical association with the occurrence of MACE. Conclusions No association has been found between different electrocardiographic LVH criteria and the incidence of MACE in a cohort of hypertensive patients followed-up in a PHC setting for 12 years.