QTc interval in young Gujarati hypertensives: Effect of disease, antihypertensive monotherapy, and coexisting risk factors

Abstract

Objectives:To study the effect of disease duration, treatment and risk factors on QTc interval among young hypertensives.Materials and Methods:A case–control study was conducted on 142 hypertensives (60 males, 82 females) taking calcium channel blocker (CCB) or angiotensin-converting enzyme inhibitor (ACEI) as monotherapy. After blood pressure measurement, we recorded lead II electrocardiograph with minimum ten waveforms. QTc was derived from average of ten values using Bazett's formula. QTc interval >0.43 s in male and >0.45 s in female was considered abnormal.Results:Cases had mean duration of hypertension 5 years, mean age of 40 years, and poor blood pressure control (systolic blood pressure >140 and diastolic blood pressure >90 mm of Hg). Newly diagnosed hypertensives had significantly higher QTc values than the matched known cases (0.44 vs. 0.42 s, P < 0.05). Known hypertensives did not differ significantly in QTc values by the duration of disease. CCB users showed small, insignificant disadvantage for abnormally prolonged QTc values than ACEI users. With coexisting diabetes, smoking, and positive family history of hypertension, there was odds risk of 7.69, 2.75, and 2.54, respectively for prolonged QTc.Conclusion:Our study showed prolonged QTc in hypertensives more so in newly diagnosed, unaffected by duration or use of ACEI, or CCB but associated with modifiable risk factors. This underscores high risk of repolarization abnormality-induced future events, suggesting early screening of hypertension, strict blood pressure control, optimum use of QTc measurement, and preventive pharmacotherapy to reduce this aftermath.

Central hemodynamics and arterial stiffness in Gujarati diabetics not receiving any antihypertensive: A case–control study based on oscillometric pulse wave analysis

“…Higher results in diabetics can also be explained by poor glycemic control despite therapy which is the feature of our diabetics. [12] Such results are in line with a study done elsewhere. [13] It can also be due to (1) unavailability of HbA1c that gives better inference about glycemic control, (2) higher prevalence of physical inactivity, (3) poor blood pressure control, (4) ethnic predisposition, (5) delayed diagnosis, and (6) lack of life style modification.…”

“…We did not find significant difference between new or old cases and with duration less than or more than 4 years with respect to PWA parameters, in line with our previous studies in diabetics with different cardiovascular parameters. [1223242526] It indicates the importance of presence of disease, early diagnosis, physical activity, and prompt treatment more than further chronicity or glycemic control.…”

Prevalence of QTc prolongation among hypertensive patients and its association with other co-morbidities

“…Endless research was nevertheless required to fortify this analysis. 2,[6][7][8] Hence, this study aimed to estimate the prevalence of QTc prolongation among hypertensive individuals and also further evaluate the interrelationship of prolonged QTc with other co-morbidities.…”

“…When these defects exist, they can be easily detected using electrocardiogram (ECG) parameters such as the QT interval. 1,2 Prolonged QT intervals have been linked to an increased risk of cardiovascular death in people with diabetes, hypertrophic cardiomyopathy and heart failure. It has also been linked to several components of insulin resistance syndrome, age, body mass index, left ventricular hypertrophy, persistently elevated blood pressure and, in some studies, female gender.…”

Relationship of Blood Pressure With QTC Interval and C-Reactive Protein

“…prone to develop hypertension in India [1]. One of the leading factors for morbidity and It is reported that one in three individuals are mortality worldwide is hypertension [2].…”