Changes in ECG pattern with advancing age

The rising prevalence of cardiovascular disease with advancing age can be attributed to the cumulative effect of the normal aging process and cardiovascular risk factor. Another factor to consider is the changing age structure of the population. The normal aging process is associated with extensive changes throughout the cardiovascular system that influence the epidemiology, clinical features, response to therapy and prognosis of cardiovascular diseases in older adults. Thus, there is a need for evaluation of cardiac status of the elderly population.

The resting electrocardiogram (ECG) permits us to suspect or diagnose a large number of cardiac disorders. As a non-invasive, less expensive and simple technique, the ECG can be even more useful in developing countries, such as India where resources are limited and cardiovascular diseases are rapidly emerging as a major health problem. The present study was carried out in 400 apparently healthy asymptomatic subjects (age range: 45-74 years) selected from the general population of Solapur city. All these subjects were screened for prevalence of various ECG abnormalities in relation to age by recording resting 12-lead electrocardiogram. ECGs were coded and classified as abnormal, according to the Minnesota code system.

This study has outlined the overall relationship between the electrocardiographic abnormalities and advancing age. Indeed, the close parallel relationship between the incidence of abnormal ECG and advancing age found in our study suggests that the ECG can be a highly reliable indicator of heart disease even in sixth or seventh decades when the validity of other parameters, such as history or symptoms is often diminished.

In summary, the ECG in apparently healthy asymptomatic subjects identifies subgroups at high risk of cardiovascular diseases. Thus, the resting ECG is an office-based test capable of identifying symptomless heart disease and determining which patient should be referred for further non-invasive testing or cardiac catheterization.