Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .
Left ventricular hypertrophy on electrocardiogram: prognostic implications from a 10-year cohort study of older subjects: a report from the Bronx Longitudinal Aging Study.
OBJECTIVE The objective of this study was to report on the prevalence , incidence and prognosis of left ventricular hypertrophy ( LVH ) on the electrocardiogram ( ECG ) in a cohort of ambulatory older men and women . DESIGN A prospect i ve , longitudinal study of 10 years duration with ECGs obtained at baseline and on an annual basis . SETTING AND PATIENTS A community-based cohort study consisting of 459 subjects ( aged 75 - 85 , mean age 79 years ) . MEASUREMENTS Baseline and follow up ECGs  were interpreted using the Minnesota Code . Prevalence and incidence of  LVH  and  ECG  were determined as well as regression of ECG LVH . Clinical event rates measured were incidence of total mortality , myocardial infa rct ion ( MI , fatal and non-fatal ) , cardiovascular mortality , cardiovascular disease ( fatal and non-fatal ) , stroke ( fatal and non-fatal ) , all-cause dementia , and multi-infa rct dementia . Differences in event rates between groups ( those subjects with and without LVH ) were compared as tests between proportions . A Cox Proportional Hazards Regression Analysis was performed to compare the relative independent predictive values of different competing factors , including age , gender , serum cholesterol , digitalis use , body mass , index , Blessed Dementia Scale , cigarette smoking , LVH at baseline , LVH ar baseline ( persisting ) , new LVH , new LVH ( persisting ) , new LVH ( regressed ) , previous MI by history of ECG , hypertension by history , and cardiomegaly by X-ray ( cardiothoracic ratio > or = 50 % ) . RESULTS At baseline , 9.2 % of subjects ( n = 42 ) had LVH on ECG and a mortality rate of 11.7/100 persons years versus 4.9/100 persons years for subjects without baseline LVH ( P < .0001 ) , and MI rate of 7.5/100 persons years with LVH versus 2.6/100 persons years without LVH ( P < .0001 ) , and a cardiovascular mortality rate of 7.2/100 persons years without LVH versus 2.7/100 person years without LVH . Subjects who developed new LVH on ECG ( n = 39 ) had a mortality rate of 14.4/100 person-years compared with 4.4/100 person-years for those without LVH ( P < .0001 ) , a cardiovascular mortality rate of 11.1/100 person years versus 2.0/100 person years without LVH ( P < .0001 ) , and an MI rate of 6.1/100 person years versus 2.0/100 person years without LVH ( P < .01 ) . Subjects in whom the ECG LVH pattern disappeared over time had fewer cardiovascular mortal and morbid events than those with persistent LVH . According to the regression analyses , persistent LVH from baseline was an independent predictor of MI , overall cardiovascular disease , and total mortality . Newly developing LVH with subsequent regression was an independent predictor of overall cardiovascular disease and death . CONCLUSIONS An increased prevalence and incidence of LVH on ECG , irrespective cause , is associated with a poor prognosis in very old men and women . Regression of ECG LVH in older people , irrespective of cause , may confer improvement in risk for cardiovascular disease
Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .