Healy Caroline F, Lloyd-Jones Donald M
From the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Cardiol Rev. 2016 Jul-Aug;24(4):163-9. doi: 10.1097/CRD.0000000000000109.
Electrocardiographic (ECG) abnormalities are prevalent in middle aged and are associated with risk of adverse cardiovascular events. It is unclear whether and to what extent traditional risk factors are associated with the development of ECG abnormalities. To determine whether traditional cardiovascular risk factors are associated with the presence or development of ECG abnormalities, we performed a systematic review of the English-language literature for cross-sectional and prospective studies examining associations between traditional cardiovascular risk factors and ECG abnormalities, including major and minor ECG abnormalities, isolated nonspecific ST-segment and T-wave abnormalities, other ST-segment and T-wave abnormalities, QT interval, Q waves, and QRS duration. Of the 202 papers initially identified, 19 were eligible for inclusion. We examined data analyzing risk factor associations with ECG abnormalities in individuals free of cardiovascular disease. For composite major or minor ECG abnormalities, black race, older age, higher blood pressure, use of antihypertensive medications, higher body mass index, diabetes, smoking, and evidence of left ventricular hypertrophy or higher left ventricular mass are the factors most commonly associated with prevalence and incidence. Risk factor associations differ somewhat according to types of specific ECG abnormalities. Because major and minor ECG abnormalities have important and independent prognostic significance, understanding the groups at risk for their development may inform prevention strategies focused on modifiable risk factors to reduce the burden of ECG abnormalities, which may in turn promote CVD prevention.
心电图（ECG）异常在中年人中很常见，并且与不良心血管事件风险相关。传统危险因素是否以及在何种程度上与心电图异常的发生相关尚不清楚。为了确定传统心血管危险因素是否与心电图异常的存在或发生相关，我们对英文文献进行了系统回顾，以查找横断面研究和前瞻性研究，这些研究考察了传统心血管危险因素与心电图异常之间的关联，包括主要和次要心电图异常、孤立的非特异性ST段和T波异常、其他ST段和T波异常、QT间期、Q波和QRS时限。在最初确定的202篇论文中，19篇符合纳入标准。我们检查了分析无心血管疾病个体中危险因素与心电图异常关联的数据。对于复合性主要或次要心电图异常，黑人种族、年龄较大、血压较高、使用抗高血压药物、体重指数较高、糖尿病、吸烟以及左心室肥厚或左心室质量较高的证据是与患病率和发病率最常相关的因素。危险因素的关联根据特定心电图异常的类型略有不同。由于主要和次要心电图异常具有重要且独立的预后意义，了解有发生这些异常风险的人群可能有助于制定侧重于可改变危险因素的预防策略，以减轻心电图异常的负担，这反过来可能促进心血管疾病的预防。
