RT Journal Article
SR Electronic
T1 Electrocardiography for the detection of left ventricular hypertrophy in an elderly population with long-standing hypertension in primary care: a secondary analysis of the CHELLO cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e038824
DO 10.1136/bmjopen-2020-038824
VO 10
IS 8
A1 de Hartog-Keyzer, Josephine Madeleine Louise
A1 El Messaoudi, Saloua
A1 Harskamp, Ralf
A1 Vart, Priya
A1 Ringoir, Lianne
A1 Pop, Victor
A1 Nijveldt, Robin
YR 2020
UL http://bmjopen.bmj.com/content/10/8/e038824.abstract
AB Objectives To investigate: (1) the prevalence of left ventricular hypertrophy (LVH) in elderly primary care patients with long-standing asymptomatic hypertension, and (2) the diagnostic value of ECG as a screening tool in the detection of LVH compared with echocardiography in this specific patient population.Design and settings A cross-sectional study in five general practices in the south-east of the Netherlands.Participants Patients with primary care-managed hypertension, aged between 60 and 85 years, without known heart failure.Primary and secondary outcome measures Between June 2010 and January 2013, the patients underwent structured interviews, blood pressure assessment, laboratory testing, ECGs and echocardiograms. The primary outcome was to investigate the ability of ECG to detect LVH, compared with echocardiography as a reference test (gold standard).Results Four hundred and twenty-two patients (44% male; ages 70±7 years) who underwent ECG and echocardiographic assessment to determine LVH were included. The median duration of hypertension was 10 (4–15) years. The overall prevalence of LVH was 44%, which increased with age (p<0.001); up to 60% of patients were ≥75 years. ECG intimated LVH in 47 patients (11%) but in only 26 of those (55%) was LVH confirmed by echocardiography. The sensitivity of ECG for detecting LVH was poor (14%).Conclusions Asymptomatic primary care patients with long-standing hypertension have a high prevalence of previously undetected LVH, which increases with age. ECG is inadequate for detecting LVH in these patients. Early detection of LVH could potentially create more awareness for the optimal regulation of hypertension and compliance to therapy. Therefore, echocardiography should be considered a screening device for the detection of LVH in this population.