Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Prevalence of left-ventricular hypertrophy by multiple electrocardiographic criteria in general population: Hermex study

Félix-Redondo, Francisco J.a; Fernández-Bergés, Danielb; Calderón, Albertoc; Consuegra-Sánchez, Lucianod; Lozano, Luíse; Barrios, Vivenciof

doi: 10.1097/HJH.0b013e3283546719

Objectives: To determine the prevalence of left-ventricular hypertrophy (LVH) in the general population by means of multiple electrocardiographic criteria and those variables independently associated.

Methods: Random-sample cross-sectional study of the general population aged between 25 and 79 years, representative of a health area, was conducted. An electrocardiogram was recorded ‘on line’ in the Electropres project website; 17 LVH criteria together with two combined criteria were used. By multivariate analysis we examined those variables independently associated with the presence of electrocardiographic LVH.

Results: We recruited 2564 individuals, mean age 50.9 [standard deviation (SD) 14.7] years, 45.7% men. The criteria more prevalent were: Dalfó 19.4%, RV6/V5 14.5%, Perugia 10.9%, any combination with at least three positive criteria (Combined 3) 9.4%, Romhilt 7.5%, Lewis 6.2% and the recommended criteria of the European Society of Hypertension 4%. The best prevalence ratio between hypertensive and normotensive individuals was achieved with Lewis, Dalfó and Perugia criteria. The least prevalence was Sokolow 0.7%. The variables that were independently associated with the presence of LVH by Combined 3 criterion were pulse pressure at least 50 [odds ratio (OR) 2.13, 95% confidence interval (CI) 1.47–3.09], arterial hypertension (OR 1.75, 95% CI 1.21–2.53) and smoking (OR 0.69, 95% CI 0.50–0.95).

Conclusions: The detection ability of the electrocardiogram with regard to the LVH may improve with the use of other criteria than those currently recommended by the guidelines. The presence of LVH is positively associated with hypertension and elevated pulse pressure and negatively with a history of smoking.

aCentro de Salud Villanueva Norte

bCardiovascular Diseases Program. Research Unit Health Area Don Benito-Villanueva de la Serena, Villanueva de la Serena, Badajoz

cCentro de Salud Rosa Luxemburgo, San Sebastián de los Reyes, Madrid

dDepartament of Cardiology, Hospital Universitario de Santa Lucía, Cartagena, Murcia

eCentro de Salud Urbano I, Mérida, Badajoz

fDepartament of Cardiology, Hospital Ramón y Cajal, Madrid, Spain

Correspondence to Francisco Javier Félix Redondo, Plaza de Salamanca n° 9, Villanueva de la Serena (Badajoz), Spain. E-mail:

Abbreviations: CVD, cardiovascular disease; HTN, arterial hypertension; LVH, left-ventricular hypertrophy; PP, pulse pressure; SD, standard deviation; VDP, voltage-duration product

Received 29 October, 2011

Revised 12 March, 2012

Accepted 3 April, 2012

© 2012 Lippincott Williams & Wilkins, Inc.