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[高血压患者进行心电图检查的推荐频率]

[The recommendable frequency for performing electrocardiograms in the hypertension patient].

作者信息

Vinyoles E, Davins J, Mata M, Contijoch C, Contreras C, de la Figuera M

机构信息

CAP La Mina. Sant Adrià del Besós, Barcelona.

出版信息

Aten Primaria. 1993 Nov 30;12(9):608-10.

PMID:8297989
Abstract

OBJECTIVE

To obtain information on how often electrocardiograms (ECG) should be carried out during hypertense patients' follow-up.

DESIGN

A retrospective, descriptive study.

SETTING

La Mina Primary Care Centre.

PATIENTS

Out of 1780 hypertense patients over 14 years old monitored at our Health Centre, 352 were selected by random sampling.

MEASUREMENTS AND MAIN RESULTS

Their first ECG after the AHT diagnosis was analysed. Those patients with a normal initial ECG, a minimum of one year's monitoring, and absence of a chronic limitation of air flow, diabetes mellitus or cardiopathy were included in the study. The ECGs following the first ECG were analysed sequentially until an anomalous ECG was detected. Final sample: 98 patients (average age 53, SD 12.8; 33 men and 65 women). 89 (91.8%) had light-to-moderate AHT. The average interval between the initial normal ECG and the first pathological ECG was 36 months (SD 16.9). The most common electrocardiographic irregularities were the T minor wave (34.5%), the greater unevenness of the ST (17.2%) and left ventricular hypertrophy (13.8%). A total of 29 patients presented a pathological ECG during an average monitoring period of 61 months (C.I. 95%; 50-72). These were only significantly different from the remaining 69 as regards age. Those patients over 54 (n = 51) had significantly more irregularities (21) than those under 55 (n = 47) (8 irregularities) (p = 0.006), the main increase being between the ages of 55 and 60.

CONCLUSIONS

The recommendation to carry out an ECG every 2 or 3 years when monitoring a hypertense patient with a normal initial ECG and without additional pathologies, could be extrapolated from our study. The time interval could be shortened for older patients.

摘要

目的

获取有关高血压患者随访期间应多久进行一次心电图(ECG)检查的信息。

设计

一项回顾性描述性研究。

地点

拉米纳初级保健中心。

患者

在我们健康中心监测的1780名14岁以上高血压患者中,通过随机抽样选取了352名。

测量与主要结果

分析了他们在高血压诊断后的首次心电图。纳入研究的患者需首次心电图正常、至少监测一年且无气流慢性受限、糖尿病或心脏病。依次分析首次心电图后的心电图,直至检测到异常心电图。最终样本:98名患者(平均年龄53岁,标准差12.8;33名男性和65名女性)。89名(91.8%)患有轻度至中度高血压。初始正常心电图与首次病理性心电图之间的平均间隔为36个月(标准差16.9)。最常见的心电图异常为T波低平(34.5%)、ST段抬高不均(17.2%)和左心室肥厚(13.8%)。在平均61个月的监测期内(95%置信区间;50 - 72),共有29名患者出现病理性心电图。这些患者与其余69名患者仅在年龄方面存在显著差异。54岁以上的患者(n = 51)出现异常(21例)明显多于55岁以下的患者(n = 47)(8例异常)(p = 0.006),主要增加发生在55岁至60岁之间。

结论

对于初始心电图正常且无其他病变的高血压患者进行监测时,每2或3年进行一次心电图检查的建议可从我们的研究中推断得出。对于老年患者,时间间隔可缩短。

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