S-29-6: ELECTROCARDIOGRAPHIC ABNORMALITIES AMONG NEWLY PRESENTING HYPERTENSIVE PATIENTS: REPORT FROM CARDIOVASCULAR RISK PREDICTION REGISTRY
Authors: Adeoye Abiodun Moshood , Adebayo Oladimeji , Onyeaghala Augustine , Fakunle Adekunle , Adebusoye Lawrence 
Published: January 2023

Background:
Cardiovascular diseases (CVDs) have become a significant public health concern globally. Standard electrocardiography (ECG) remains an essential diagnostic procedure for cardiovascular risk stratification in hypertension. The co-existence of electrocardiographic abnormalities with hypertension is associated with an increased risk of cardiovascular morbidity and mortality. Data showing electrocardiographic abnormalities among newly diagnosed hypertensives in this environment is limited.

Objective:
To provide the spectrum of ECG abnormalities among newly presenting hypertensive patients seen at the University College Hospital, Ibadan.

Design and method:
This observational study was conducted using data from the Cardiovascular Risk Prediction (CRP) registry domiciled at University College Hospital (UCH). Data collection spanned from 2019 to 2022. New patients presenting with hypertension at the cardiology clinic were received and assessed, and cardiovascular risk factors were stratified to identify cardiovascular morbidity and mortality indicators. All participants underwent standard 12 lead ECG. Fasting venous blood was collected to assess serum electrolytes, urea, creatinine, and lipid panels. Statistical Analysis was performed using Statistical Package for Social Sciences (SPSS) version 21.

Results:
Six hundred and twelve participants comprising 49.7% of women with a mean age of 53.66 ± 15.5 years with complete ECG interpretations were analyzed. A third of the participants had Left ventricular hypertrophy (LVH), with one in ten having strain patterns. About 19%, 10.6%, and 1.8% of participants presented with conduction abnormalities, left atrial enlargement (LAE), and atrial fibrillation, respectively. Mean age, blood pressure parameters, and QT/QTc intervals were comparable in both sexes. Compared to women, men had higher mean urea (29.81 ± 14.1 vs 26.45 ± 11.3 mg/dl;p < 0.002) and creatinine (1.21 ± 0.6 vs 0.94 ± 0.4 mg/dl; p < 0.0001)) and greater proportion of conduction abnormalities (22.1% vs 15.9%;p = 0.05), LVH(36.9% vs 27.6%;p = 0.014), LVH plus strain pattern(13.4% vs 7.0%;p = 0.009), and LAE (13.5% vs 0.7%;p = 0.019). Women were heavier with higher mean total cholesterol (191.75 ± 44.5 vs. 179.92 ± 47.9 mg/dl; p < 0.004) and LDL cholesterol (121.83 ± 37.6 vs. 114.35 mg/dl; p = 0.21). Participants with LVH had higher mean Systolic (146.87 ± 24.7 vs142.19 ± 23.1 mmHg; p = 0.023) and diastolic blood pressure (91.15 ± 16.5 vs 85.97 ± 13.4mmHg; < 0.0001),creatinine (1.15 ± 0.7 vs 1.04 ± 0.41 mg/dl; p = 0.017) and QTc interval (483 ± 83.5 vs 463.81 ± 55.6; ms p < 0.007) and coexisted with LAE compared with those without LVH.

Conclusion:
Left ventricular hypertrophy was the predominant abnormality in the studied population. Abnormal ECG findings were more common in men, and those with LVH had more cardiovascular risk than women. Early identification and management of these risks are essential in preventing cardiovascular morbidity and mortality.