Background
We evaluated the prevalence of major and minor electrocardiographic (ECG) abnormalities based on blood pressure (BP) control and hypertension (HTN) treatment resistance.
Methods
We analyzed data from the REGARDS study of 20,932 participants who were divided into presence of major (n = 3,782), only minor (n = 8,944) or no (n = 8,206) ECG abnormalities. The cohort was stratified into normotension (n = 3,373), prehypertension (n = 4,142), controlled HTN (n = 8,619), uncontrolled HTN (n = 3,544), controlled apparent treatment resistant HTN (aTRH n = 400) and uncontrolled aTRH (n = 854) groups and the prevalence ratios (PR) of major and minor ECG abnormalities were assessed separately for each BP group. The full multi-variable adjustment included demographics, risk factors and HTN duration.
Results
Compared with normotension, the PRs of major ECG abnormalities for prehypertension, controlled HTN, uncontrolled HTN, controlled aTRH and uncontrolled aTRH groups were 1.01 (0.90 – 1.14), 1.30 (1.16 – 1.45), 1.37 (1.23 – 1.54), 1.42 (1.22 – 1.64) and 1.44 (1.26 – 1.65) respectively (p < 0.001), whereas, the PRs of minor ECG abnormalities among each of the above BP groups were similar.
Conclusion
Detection of major ECG abnormalities among hypertensive persons with poor control and treatment resistance may help improve their cardiovascular risk stratification and early intervention.