Prevalence of electrocardiographic abnormalities in a middle-aged, biracial population: Coronary Artery Risk Development in Young Adults study

Abstract 

Background

Few studies to date have described the prevalence of electrocardiographic (ECG) abnormalities in a biracial middle-aged cohort.

Methods and Results

Participants underwent measurement of traditional risk factors and 12-lead ECGs coded using both Minnesota Code and Novacode criteria. Among 2585 participants, of whom 57% were women and 44% were black (mean age 45 years), the prevalence of major and minor abnormalities was significantly higher (all P < .001) among black men and women compared to whites. These differences were primarily due to higher QRS voltage and ST/T-wave abnormalities among blacks. There was also a higher prevalence of Q waves (Minnesota Code 1-1, 1-2, 1-3) than described by previous studies. These racial differences remained after multivariate adjustment for traditional cardiovascular (CV) risk factors.

Conclusions

Black men and women have a significantly higher prevalence of ECG abnormalities, independent of traditional cardiovascular risk factors, than whites in a contemporary cohort of middle-aged participants.

Keywords: ECG abnormalities, Prevalence racial differences, Cardiovascular risk factors

• 1 Minnesota Code voltage criteria: 3.1 plus repolarization abnormalities: 4.1 or 4.2 or 4.3 or 5.1 or 5.2 or 5.3.
• 2 Cornell voltage (CV) more than 2200 μV for women; more than 2800 μV for men.
• 3 Cornell voltage product more than 244 microvolt seconds = CVQRS duration.
• 4 A method developed by Rautaharju et al.

  White women	ECG LVM (g) = 0.02 × CV + (1.12 × BW⁎) + 36.2
  Black women	ECG LVM (g) = 0.023 × CV + (0.87 × BW) + 37.6
  White men	ECG LVM (g) = 0.026 × CV + (1.25 × BW) + 34.4
  Black men	ECG LVM (g) = 0.024 × CV + (1.18 × BW) + 34.8

  ^⁎BW = weight in kilograms; CV, Cornell voltage.
• 5 All values statistically significant to P < .0001.