Electrocardiogram derived QRS duration associations with elevated central aortic systolic pressure (CASP) in a rural Australian population

Abstract

BackgroundProlonged electrocardiogram QRS durations are often present in hypertensive patients. Small increases in QRS duration serve as independent risk factors for both increased cardiovascular and all-cause mortality. Aortic stiffness is associated with increases in central aortic systolic blood pressure (CASP). However CASP and ECG QRS duration interactions have not been established in rural community populations. Our aims are to determine if QRS duration > 100 msec is associated with an elevated CASP measure in an Australian rural population.MethodsA retrospective cross sectional population was obtained from the CSU Diabetes Screening Research Initiative data base where 68 participants had both central aortic pressure recorded and ECG derived QRS duration. Central aortic pressure was determined by directly recording radial arterial tonometry and brachial cuff pressure (HealthStats, Singapore). Resting 12-lead electrocardiograms were obtained from each subject using a Welch Allyn PC-Based ECG system.ResultsThe population had a mean CASP of 137.8 mmHg, higher than previously reported in other population studies. In 8/68 subjects with a prolonged cardiac QRS duration >120 msec, CASP ranged from 129 mmHg – 182 mmHg. When subgroup analysis was stratified on the basis QRS duration <100 msec and ≥100 msec significant differences (p = 0.036) were observed for mean CASP, 130.6 mmHg ± 15.6 (SD) versus 140.6 mmHg ± 16.8 (SD), respectively.ConclusionsOur results suggest that an arbitrary CASP reading greater than a value 140 mmHg raises suspicion of a prolonged QRS duration. QRS durations ≥100 msec in an aging rural population are associated with higher CASP measures. Our results also suggest in aging Australian rural populations CASP is likely to be elevated, possibly due to age related aortic stiffening.

Baseline Framingham risk score does not predict future ECG-derived QRS duration over an average of 3.3 years

“…On the other hand, the mean age of our study population was 68.2 years, where central aortic stiffening could theoretically influence systolic blood pressure changes that could increase QRS duration (over a short period of time). A previous cross-sectional study, representative of our study population, demonstrated higher than expected central aortic blood pressure [23] in rural Australia. Many of the risk factors that comprise the Framingham risk score can influence QRS duration.…”

“…We do not have data on medications that may have influenced QRS duration in this study. On the other hand, we appreciate that in rural areas of Australia medication use and compliance is low for cardiovascular medications [23,24]. Additionally, we do not have strict diagnosis of whether bundle branch block was evident at higher QRS durations in our population.…”

Epigenetic status of subtelomere of peripheral leukocytes corresponds to cardiographic parameters with a sex association

“…It has been reported that aging-associated cardiac dysfunction is related to an aged condition accompanying telomere shortening in somatic cells. [12][13][14][15][16][17][18] Therefore, electro-or echocardiographic variables can be indices of individual genomic aging.…”

Community-based intervention for blood pressure reduction in Nepal (COBIN trial): study protocol for a cluster-randomized controlled trial

“…People 25–65 years of age who are listed in the voter list of 2007 are eligible for inclusion in the baseline survey. The primary endpoint of the study is a reduction in SBP, because with aging there is an increase in SBP due to aortic stiffening [ 24 ]. This may not be modifiable through reduction in risk factors.…”