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Blood pressure-related electrocardiographic findings in healthy young individuals
Gerardus J Hassing1, Hein E C van der Wall1,2, Gerard J P van Westen2
1Centre for Human Drug Research, Leiden, The Netherlands.
Insights
Even in healthy young adults, higher normal blood pressure is linked to early cardiac changes. These include increased ventricular rate and signs of hypertrophy on electrocardiograms, suggesting potential cardiovascular risk.
Area of Science:
- Cardiology
- Clinical Physiology
Background:
- Elevated blood pressure is a known risk factor for cardiovascular disease.
- Hypertension can lead to electrocardiographic (ECG) changes indicative of cardiac strain.
- Early detection of cardiac changes in young adults with high-normal blood pressure is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To investigate the association between normal to high-normal blood pressure levels (90-139/50-89 mmHg) and ECG parameters in healthy young adults.
- To identify early electrocardiographic signs of cardiac adaptation to blood pressure within the normal range.
- To assess potential links between blood pressure and cardiac changes predictive of future hypertension complications.
Main Methods:
- Analysis of ECG data from 1449 healthy volunteers aged 18-30 years with blood pressure between 90-139/50-89 mmHg.
- Grouping subjects by 10 mmHg systolic blood pressure increments to compare ECG parameters.
- Multivariate regression analysis to determine independent associations between blood pressure and ECG variables, controlling for gender, BMI, and cholesterol.
Main Results:
- Significant differences in ECG parameters including P-wave area, ventricular activation time, QRS duration, and hypertrophy indices (Sokolow-Lyon, Cornell Product) were observed between systolic blood pressure groups.
- Ventricular rate, ventricular activation time, Sokolow-Lyon voltage, and Cornell product were independently associated with systolic blood pressure.
- Ventricular rate, P-wave area, and Cornell product were independently associated with diastolic blood pressure.
Conclusions:
- Blood pressure within the normal range incrementally influences ECG parameters in healthy young adults.
- Observed changes include increased ventricular rate, atrial surface area, ventricular activation time, and ventricular hypertrophy indices.
- These findings suggest that even high-normal blood pressure may be associated with subclinical cardiac adaptations, warranting further investigation into long-term cardiovascular risk.
Abstract:
Purpose: Elevated blood pressure induces electrocardiographic changes and is associated with an increase in cardiovascular disease later in life compared to normal blood pressure levels. The purpose of this study was to evaluate the association between normal to high normal blood pressure values (90-139/50-89 mmHg) and electrocardiographic parameters related to cardiac changes in hypertension in healthy young adults.Methods: Data from 1449 volunteers aged 18-30 years collected at our centre were analyzed. Only subjects considered healthy by a physician after review of collected data with systolic blood pressure values between 90 and 139 mmHg and diastolic blood pressure values between 50 and 89 mmHg were included. Subjects were divided into groups with 10 mmHg systolic blood pressure increment between groups for analysis of electrocardiographic differences. Backward multivariate regression analysis with systolic and diastolic blood pressure as a continuous variable was performed.Results: The mean age was 22.7 ± 3.0 years, 73.7% were male. P-wave area, ventricular activation time, QRS-duration, Sokolow-Lyon voltages, Cornell Product, J-point-T-peak duration corrected for heart rate and maximum T-wave duration were significantly different between systolic blood pressure groups. In the multivariate model with gender, body mass index and cholesterol, ventricular rate (standardized coefficient (SC): +0.182, p < .001), ventricular activation time in lead V6 (SC= +0.065, p = .048), Sokolow-Lyon voltage (SC= +0.135, p < .001), and Cornell product (SC= +0.137, p < .001) were independently associated with systolic blood pressure, while ventricular rate (SC= +0.179, p < .001), P-wave area in lead V1 (SC= +0.079, p = .020), and Cornell product (SC= +0.091, p = .006) were independently associated with diastolic blood pressure.Conclusion: Blood pressure-related electrocardiographic changes were observed incrementally in a healthy young population with blood pressure in the normal range. These changes were an increased ventricular rate, increased atrial surface area, ventricular activation time and increased ventricular hypertrophy indices on a standard 12 lead electrocardiogram.
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