Incidencia de alteraciones electrocardiográficas en la hipertensión arterial. Estudio MINACOR

Con objeto de analizar la incidencia de alteraciones electrocardiográficas (ALT-ECG) y sus posibles factores predictores se ha llevado a cabo un estudio prospectivo de 5 años de duración en una cohorte de 364 pacientes hipertensos libres de enfermedad cardiovascular y atendidos en un centro urbano de Atención Primaria. Se excluyeron los pacientes mayores de 55 años, diabéticos y con cardiopatía previa. Anualmente se realizaron ECG que fueron analizados de acuerdo con las clasificaciones del Pooling Project y de Minnesotta. Del total de 156 pacientes con un ECG basal normal, un 18,6 % (n = 29) presentaron ALT-ECG en un término medio de 41,4 ± 19,1 meses. Las ALT-ECG más incidentes fueron las del segmento terminal, 26 sobre 31 (83,9 %). El análisis de regresión logística demostró que un mal control de la presión arterial (PA) durante el seguimiento (PA >140/90 mmHg) era la única condición significativamente asociada a un incremento del riesgo de presentar ALT-ECG, con una odds ratio de 3,2 (IC 95%: 1,2-8,6).

With the objective to analyze the incidence of electrocardiographic alterations (ECG-ALT) and their potential pridictive factors, a 5-year long prospective study was conducted with a cohort of 364 hypertensive patients free of cardiovascular disease and attended at an urban Primary Care Center. Patients over 55 years, diabetic patients and those with previous heart disease were excluded from the study. Yearly, ECG determinations were obtained which were analyzed according to the Pooling Project and Minnesotta scores. Out of 156 patients with a normal basal electrocardiogram, 18.6 % (n=29) had ECG-ALT in a mean time of 41.9±19.1 months. The most incident ECG-ALTs were those in the terminal segment, 26 out of 31 (83.9%). The logistic regression analysis demonstrated that a poor blood pressure (BP) control during follow-up (BP>140/90 mmHg) was the only condition significantly associated with an increment in the risk of having ECG-ALT, with and odds ratio of 3.2 (95 CI: 1.2-8.6).