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[The usefulness of the annual electrocardiogram in arterial hypertension follow-up]
L García Olmos1, M T Alonso, O Olmos
1Centro de Salud de Alcobendas, Madrid.
Insights
Electrocardiograms (ECGs) in hypertension management showed moderate agreement between primary care and specialists. General practitioners frequently misdiagnosed conditions, indicating potential quality of care issues despite protocol adherence.
Area of Science:
- Cardiology
- Hypertension Management
- Primary Care
Background:
- Hypertension requires regular monitoring to prevent complications.
- Electrocardiograms (ECGs) are used to assess cardiac health in hypertensive patients.
- The role of primary care physicians in interpreting ECGs for hypertension follow-up needs evaluation.
Purpose of the Study:
- To assess the utility of ECGs in managing hypertensive patients.
- To evaluate the diagnostic agreement between primary care physicians and cardiologists for ECG interpretation.
- To determine if protocol adherence ensures quality of care in hypertension management.
Main Methods:
- A cohort of 223 hypertensive patients in a control program was studied.
- Yearly ECGs were requested for 84.3% of patients.
- ECG interpretations by primary care teams were compared with cardiologist assessments for 122 tracings.
Main Results:
- ECG interpretation led to therapeutic changes in only 6 patients.
- Moderate agreement was found between primary care and cardiology ECG interpretations.
- General practitioners overdiagnosed normal ECGs and underdiagnosed left ventricular hypertrophy and ischemic heart disease compared to cardiologists.
Conclusions:
- Routine ECGs in hypertension follow-up may have limited impact on immediate therapeutic changes.
- Discrepancies in ECG interpretation highlight potential gaps in primary care expertise.
- Adherence to a protocol does not automatically ensure high-quality cardiac care for hypertensive patients.
Abstract:
We evaluated the usefulness of ECG in the follow up of 223 hypertensive patients included in a program for the control of hypertension. Yearly ECG was requested in 84.3% of the evaluated patients. Its interpretation resulted in therapeutic changes in 6 patients. The agreement of the interpretation of 122 ECG tracings between the primary care team and a cardiologist was moderate. General practitioners overrated normality (87 versus 69 cases), and underdiagnosed left ventricular hypertrophy (6 versus 10 cases) and ischemic heart disease (6 versus 17 cases). Half of the diagnoses of ischemic heart disease made by the general practitioner were not accepted by the cardiologist. The compliance with a protocol does not guarantee a higher quality of care.