Department of Family Medicine, Wong Siu Ching Family Medicine Centre, New Territories East Cluster, Hospital Authority, G/F, 1 Po Wu Lane, Tai Po, Hong Kong SAR, China.
Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong SAR, China.
BMC Cardiovasc Disord. 2022 May 18;22(1):225. doi: 10.1186/s12872-022-02662-1.
Hypertension is strongly associated with cardiovascular events. Studies have shown that electrocardiographic (ECG) abnormalities were associated with increased risks for cardiovascular events. However local data is limited. The objectives of this study were: (1) to determine the prevalence of major electrocardiographic abnormalities in patients with hypertension in primary care in Hong Kong, and (2) to determine the association of major electrocardiographic abnormalities with patients' socio-economical background, cardiovascular disease and cardiovascular risk factors.
This was a cross-sectional study. Subjects were hypertensive patients aged between 18 and 80 who were enrolled in the Risk Assessment and Management Programme (RAMP) in a general outpatient clinic in Hong Kong. Outcome measures were prevalence of probable ischaemic heart disease (IHD), complete left bundle branch block (LBBB), left ventricular hypertrophy (LVH) and atrial fibrillation (AF) in patients with hypertension. The Pearson Chi-square test, independent t-test and Mantel-Haenszel test were used to measure the association between socioeconomic characteristics and cardiovascular risk factors, and ECG abnormalities.
504 hypertensive patients aged 18-80 were recruited in a general outpatient clinic. 6.3% had probable IHD, 0.4% had complete LBBB, 4.0% had LVH and 1.0% had AF. Probable IHD was associated with smoking (P = 0.032), hypercholesterolaemia (P = 0.037) and higher 10-year CV risk (P = 0.04). Complete LBBB was associated with smoking (P = 0.021) and hypercholesterolaemia (P = 0.022). LVH was associated with male gender (P = 0.001) and longer duration of hypertension (P = 0.035). AF was not significantly associated with any of the clinical or sociodemographic parameters.
This study showed that a significant proportion of patients with hypertension at the primary care setting in Hong Kong had probable ischaemic heart disease, left ventricular hypertrophy and atrial fibrillation. This finding is consistent with both overseas data and historic data in Hong Kong. The detection of electrocardiographic abnormalities is helpful in hypertension management by improving risk stratification.
高血压与心血管事件密切相关。研究表明，心电图（ECG）异常与心血管事件风险增加有关。然而，本地数据有限。本研究的目的是：（1）确定香港基层医疗中心高血压患者主要心电图异常的患病率，（2）确定主要心电图异常与患者社会经济背景、心血管疾病和心血管危险因素的关系。
这是一项横断面研究。研究对象为年龄在 18 至 80 岁之间的高血压患者，他们参加了香港一家普通门诊的风险评估和管理计划（RAMP）。主要观察指标为高血压患者中可能的缺血性心脏病（IHD）、完全左束支传导阻滞（LBBB）、左心室肥厚（LVH）和心房颤动（AF）的患病率。采用 Pearson 卡方检验、独立 t 检验和 Mantel-Haenszel 检验来衡量社会经济特征和心血管危险因素与心电图异常之间的关系。
在一家普通门诊共招募了 504 名年龄在 18-80 岁的高血压患者。6.3%有疑似 IHD，0.4%有完全 LBBB，4.0%有 LVH，1.0%有 AF。疑似 IHD 与吸烟（P=0.032）、高胆固醇血症（P=0.037）和较高的 10 年心血管风险（P=0.04）有关。完全 LBBB 与吸烟（P=0.021）和高胆固醇血症（P=0.022）有关。LVH 与男性（P=0.001）和高血压病程较长（P=0.035）有关。AF 与任何临床或社会人口学参数均无显著相关性。
本研究表明，香港基层医疗中心高血压患者中，有相当一部分患者患有疑似缺血性心脏病、左心室肥厚和心房颤动。这一发现与海外数据和香港历史数据一致。心电图异常的检测有助于通过改善风险分层来加强高血压的管理。
