[Cardiovascular morbidity and mortality and electrocardiographic criteria of left ventricular hypertrophy in hypertensive patients treated in primary care]. / Morbilidad y mortalidad cardiovascular y criterios electrocardiográficos de hipertrofia ventricular izquierda en pacientes hipertensos en atención primaria.

UNLABELLED: 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.

Morbilidad y mortalidad cardiovascular y criterios electrocardiográficos de hipertrofia ventricular izquierda en pacientes hipertensos en atención primaria / Cardiovascular morbidity and mortality and electrocardiographic criteria of left ventricular hypertrophia in hypertensive patients treated in primary care

Fundamento y objetivo: Los criterios electrocardiográficos de voltaje son el método de elección para el diagnóstico de hipertrofia ventricular izquierda (HVI) en atención primaria (AP). Algunos de estos se han descrito como predictores de episodios cardiovasculares (ECV). El objetivo de este estudio fue analizar la relación entre la aparición de ECV en una cohorte de hipertensos atendidos en AP y los criterios registrados. Pacientes y método: Se seleccionó aleatorizadamente a 265 hipertensos, entre todos los atendidos, que se siguieron durante 12 años. Pacientes y método: Se realizó un electrocardiograma estándar de 12 derivaciones al inicio del estudio. Se consideró ECV la aparición de cardiopatía isquémica, insuficiencia cardíaca, accidente cerebrovascular, vasculopatía periférica, arritmias o muerte por ECV. Los criterios de voltaje registrados fueron Sokolow-Lyon, Minnesota code 3.1, Gubner y Ungerleider, voltaje de Cornell y sus modificaciones de Schillaci y Dalfó. Se analizaron los datos mediante el método actuarial y modelos de regresión de Cox.Resultados: Se perdió a un 14,3% de los pacientes, cuyas características basales fueron similares a las de los que lo completaron. La mediana de tiempo de seguimiento fue de 10,1 años (intervalo intercuartílico: 5,8–12,0). La supervivencia acumulada (permanecer libre de ECV) fue del 53,5% (intervalo de confianza del 95%: 45,7–61,3). La tasa relativa media de incidencia de aparición de ECV fue de 5,85 (intervalo de confianza 95%: 4,73–6,97) por cada 100 hipertensos/año. En el análisis multivariable ninguno de los criterios mostró asociación estadística con la aparición de ECV. Conclusiones: No se observó asociación entre los criterios electrocardiográficos de HVI y la incidencia de ECV en la cohorte de hipertensos seguidos en AP durante 12 años (AU)

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. Fundamentals and objective: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. Results: The median follow-up was 10.1 years (IQR: 5.8–12.0).Results: 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 (AU)