Prevalence and prognostic value of poor R-wave progression in standard resting electrocardiogram in a general adult population. The Health 2000 Survey

Abstract

Aims. We examined the prevalence and prognostic impact of poor R-wave progression (PRWP) in a standard electrocardiogram (ECG) in a general population.

Methods. Data and standard resting ECG recording were collected from a large nationally representative (random sample) health examination survey conducted in Finland in 2000–2001. The final study population consisted of 5613 individuals.

Results. The prevalence of PRWP (defined as RV3 ≤ 3 mm and RV2 ≤ RV3) was 7.0% in women and 2.7% in men (P≤ 0.001 for difference). During follow-up of 70 ± 9 months (mean ± SD), 317 patients died (5.6%). Both all-cause and cardiovascular mortality was higher in the group with PRWP than in those without PRWP in both women and men. In Cox regression analysis after adjustment for age, hypertension, diabetes, previous myocardial infarction, and coronary heart disease, the relative risk for all-cause mortality for PRWP was 1.69 (95% CI 0.89-3.22, P=0.112) for men and 2.00 (95% CI 1.28-3.13, P=0.002) for women. For cardiovascular mortality the relative risk for individuals with PRWP was 1.85 (0.74-4.65, P=0.19) for men and 3.02 (1.54-5.93, P=0.001) for women.

Conclusions. PRWP is a common ECG finding and predicts risk for total and cardiovascular mortality in women in a general population.

Key words::

• Electrocardiography
• mortality
• outcome
• poor R-wave progression

Acknowledgements

We thank the personnel in the field and support organizations of the Health 2000 Surveys.

Declaration of interest: no conflicts of interest declared.