Racial Differences in Electrocardiographic Characteristics and Prognostic Significance in Whites Versus Asians

Area of Science:

• Cardiology
• Population Health
• Genetics

Background:

• Racial variations in electrocardiogram (ECG) patterns and their prognostic implications are not well-established.
• Understanding these differences is crucial for accurate cardiovascular risk assessment across diverse populations.

Purpose of the Study:

• To investigate racial differences in ECG characteristics between White and Asian individuals.
• To assess the differential impact of these ECG characteristics, particularly left ventricular hypertrophy (LVH), on mortality risk.

Main Methods:

• Analysis of 2677 White participants from the Framingham Heart Study and 2972 Asian participants from the Singapore Longitudinal Aging Study.
• Comparison of ECG parameters including PR interval, QT interval, and prevalence of LVH between racial groups.
• Cox proportional hazards models were used to assess the association between ECG findings and all-cause mortality over extended follow-up periods.

Main Results:

• Asians exhibited longer PR intervals and varied QT intervals compared to Whites.
• Asians had a significantly higher prevalence of ECG-defined left ventricular hypertrophy (LVH).
• LVH was associated with a greater increase in all-cause mortality risk among Asians compared to Whites (P for interaction=0.02).

Conclusions:

• Significant racial disparities exist in ECG characteristics between White and Asian populations.
• The prognostic significance of LVH on mortality differs between these racial groups.
• These findings highlight the need for race-specific ECG reference ranges and tailored cardiovascular risk assessment strategies.