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Effect of ethnicity and hypertension on atrial conduction: evaluation with high-resolution P-wave signal averaging

E C Madu1, D S Baugh, T D Gbadebo

  • 1Vanderbilt University Medical Center, Division of Cardiovascular Medicine, Nashville, Tennessee 37232-6300, USA. ernest.madu@mcmail.vanderbilt.edu

Clinical Cardiology
|September 18, 2001
PubMed

Insights

Hypertension affects atrial conduction, detectable by P-wave signal-averaged electrocardiogram (P-SAECG). Hypertensive Black patients show greater P-SAECG changes, indicating increased cardiovascular risk.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Hypertension Research

Background:

  • P-wave signal-averaged electrocardiogram (P-SAECG) measures P-wave duration and voltage integral, which are elevated in atrial fibrillation.
  • Hypertension is a primary risk factor for atrial fibrillation, especially in Black populations.
  • This study investigated P-SAECG parameters in non-atrial fibrillation patients to assess hypertension and ethnicity effects.

Purpose of the Study:

  • To determine if P-SAECG can identify hypertensive individuals.
  • To investigate if P-SAECG parameters are disproportionately higher in hypertensive Black patients compared to white patients.
  • To examine the relationship between hypertension severity and P-SAECG parameters.

Main Methods:

  • P-wave signal-averaged electrocardiogram (P-SAECG) analysis was performed on 234 normotensive and 84 hypertensive individuals.
  • An ancillary study evaluated 34 hypertensive Black men to correlate hypertension severity with P-SAECG parameters.

Main Results:

  • No significant difference in P-SAECG parameters was observed between normotensive individuals of different ethnicities.
  • Hypertensive Black patients exhibited significantly greater increases in P-wave duration and total P-wave voltage integral compared to hypertensive white patients.
  • Both P-wave duration and total P-wave voltage integral showed a positive correlation with the severity of hypertension.

Conclusions:

  • Early-stage hypertension is associated with prolonged atrial conduction and cardiac electrical remodeling, detectable by P-SAECG.
  • P-wave duration and total P-wave voltage integral increase with hypertension severity.
  • Hypertensive Black patients demonstrate more pronounced P-SAECG changes, suggesting a potentially higher cardiovascular risk compared to white patients.
Abstract

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