Abstract:
Background In Ghana and other sub-Saharan African countries, hypertension (HTN) prevalence is rapidly increasing. Hypertensive left ventricular hypertrophy (LVH) is associated with excess fibrous tissue deposition throughout the myocardium. This could lead to ventricular arrhythmias and sudden cardiac death. Increased corrected QT dispersion (QTcd) can cause ventricular repolarization and be used to identify patients at risk of ventricular tachyarrhythmia. The measurement of increased QTcd among hypertensive patients is a simple screening tool to stratify patients at cardiovascular risk. Methods A case-control hospital-based study was conducted on 200 consecutive hypertensive patients. Age- and sex-matched control groups of 200 normotensive individuals who gave informed consent were also recruited. The baseline clinical and demographic characteristics of participants were acquired using structured questionnaires. A physical examination and a resting 12-lead ECG were performed. Increased QTcd and LVH were determined. Results The mean age of hypertensive patients was 50.99±6.73 and 48.19±7.17 for the controls (p-value 0.63). The study population was predominantly female (1:2.4 male:female ratio). Higher mean values for QTcd and LVH (Sokolow-Lyon) were observed among hypertensive patients compared to controls. The prevalence of increased QTcd was 45.0% among hypertensive patients compared to 16.5% in controls (χ2 =38.14, p-value <0.0000001, odds ratio = 4.14). Conclusion Increased QTcd is prevalent among hypertensive Ghanaians. Its measurement can be an effective non-invasive screening tool to risk-stratify hypertensive patients.
摘要:
背景在加纳和其他撒哈拉以南非洲国家,高血压(HTN)患病率正在迅速增加。高血压左心室肥大(LVH)与整个心肌中多余的纤维组织沉积有关。这可能导致室性心律失常和心源性猝死。校正的QT离散度(QTcd)增加可引起心室复极,并可用于识别有室性快速性心律失常风险的患者。高血压患者中QTcd升高的测量是一种简单的筛查工具,可以对心血管风险患者进行分层。方法对200例连续高血压患者进行病例对照医院研究。还招募了年龄和性别匹配的对照组,其中包括200名接受知情同意的血压正常的个体。使用结构化问卷获得参与者的基线临床和人口统计学特征。进行了体格检查和静息的12导联ECG。确定增加的QTcd和LVH。结果高血压患者的平均年龄为50.99±6.73,对照组为48.19±7.17(p值0.63)。研究人群主要是女性(男性:女性比例为1:2.4)。与对照组相比,在高血压患者中观察到更高的QTcd和LVH(Sokolow-Lyon)平均值。高血压患者中QTcd升高的患病率为45.0%,而对照组为16.5%(χ2=38.14,p值<0.0000001,比值比=4.14)。结论QTcd升高在加纳人中普遍存在。它的测量可以成为对高血压患者进行风险分层的有效非侵入性筛查工具。