An analysis of 8,696 hypertensive patients with no history of CHF found that a unique and well-known ECG wave pattern called strain was present in 923 patients (10.6 percent). These patients had a greater than threefold increased risk of developing CHF, with a five-year rate of 8.8 percent, compared with only 2.7 percent for those without ECG strain. Additionally, patients with strain had a nearly fivefold increased risk of CHF mortality, with a five-year CHF mortality of 1.2 percent, compared with only 0.3 percent in patients without strain.
"These findings suggest that more aggressive therapy may be warranted in hypertensive patients with ECG strain to reduce the risk of CHF and CHF mortality," says Dr. Peter Okin, the study's lead investigator, and professor of medicine and director of clinical affairs in the Greenberg Division of Cardiology at Weill Medical College of Cornell University. Dr. Okin is an attending physician at NewYork-Presbyterian/Weill Cornell.
The ECG strain pattern was first identified in 1949. The pattern has previously been strongly associated with left ventricle hypertrophy (LVH) independently of coronary heart disease and with an increased risk of cardiovascular morbidity and mortality in heart patients.
Compared with patients who did not develop CHF, patients who developed CHF were older; were more likely to be black; were more likely to have diabetes and a prior history of ischemic heart disease, heart attack, stroke, and peripheral vascular disease; were more overweight; and were more likely to be current smokers. The study found that after adjusting for these factors, presence of strain was still associated with increased risk of CHF.
MEDICA.de; Source: New York-Presbyterian Hospital