Use of Electrocardiography to Predict Future Development of Hypertension in the General Population

Abstract

Cardiac muscle responds to increased afterload by developing hypertrophy. During the early stages of hypertension, the heart can be transiently, but frequently, exposed to increased afterload. This study was designed to test the hypothesis that left ventricular hypertrophy (LVH) assessed by electrocardiography (ECG) can be used to predict future development of hypertension.Sokolow–Lyon voltage and Cornell product were calculated using ECG in 5770 normotensive participants who visited our hospital for a physical checkup (age 52.7 ± 11.3 years). LVH was defined as a Sokolow–Lyon voltage of >3.8 mV or a Cornell product of >2440 mm × ms. After baseline examination, participants were followed up with the endpoint being the development of hypertension.During the median follow-up period of 1089 days (15,789 person-years), hypertension developed in 1029 participants (65.2/1000 person-years). A Kaplan–Meier analysis demonstrated a significantly higher incidence of hypertension in participants with LVH than in those without LVH as assessed by Sokolow–Lyon voltage or Cornell product (P < 0.0001 for both). The hazard ratios for incident hypertension in participants with LVH defined by Sokolow–Lyon voltage and Cornell product were 1.49 (95% confidence interval [CI] 1.16–1.90, P < 0.01) and 1.34 (95% CI 1.09–1.65, P < 0.01), respectively, after adjustment for possible risk factors. Furthermore, in multivariable Cox hazard analysis, where Sokolow–Lyon voltage and Cornell product were taken as continuous variables, both indices were independent predictors of future hypertension (P < 0.0001).Both Sokolow–Lyon voltage and Cornell product are novel predictors of future development of hypertension in the general population.

Carotid intima-media thickness is a novel predictor of new onset of hypertension in normotensive subjects

“…The concept that carotid IMT is an independent predictor of new-onset hypertension is further supported by the present analysis showing an independent correlation with changes in SBP and baseline IMT. However, it should be noted that several other factors have also been associated with the development of hypertension, including increased blood pressure within the normal range, family history of hypertension, obesity, impaired glucose tolerance, reduced glomerular filtration rate, urinary albumin, and left ventricular hypertrophy assessed by electrocardiography, [ 10 – 13 ] and carotid IMT is not the only predictor of hypertension.…”

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“…In this study, we will see if electrocardiography (ECG) can be used to predict the development of hypertension in the general population who are not hypertensive. The heart is a primary target organ for elevated blood pressure, and cardiac muscle hypertrophy occurs in response to increased afterload (i.e., systemic blood pressure), [7]. Throughout the development of hypertension, blood pressure progressively rises with large swings, indicating that the heart may be subjected to higher afterload transiently but often during the early stages of hypertension.…”

An intelligence diagnostic tool for the diagnostic of hypertension

“…The train-validation-test-evaluation was employed to validate the proposed system whereby 60% of the data was used for training, 10% for validation and the remaining 30% for testing. The results indicate that the system is able to achieve results, of similar accuracy, to that of a qualified medical device, for estimation of blood pressure.Takase et al[88] developed a convolutional neural network to identify LVH from ECG signals of 5770 subjects. The subjects were initially healthy at the start of the study, and endpoint was when they are diagnosed with HPT.…”