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Major and Minor Electrocardiographic Abnormalities and Their Association With Underlying Cardiovascular Disease and Risk Factors in Hispanics/Latinos (from the Hispanic Community Health Study/Study of Latinos)

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The association of electrocardiographic (ECG) abnormalities with cardiovascular disease and risk factors has been extensively studied in whites and African-Americans. Comparable data have not been reported in Hispanics/Latinos. The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multicenter, community-based, prospective cohort study of men and women of diverse backgrounds aged 18 to 74 years who self-identified as Hispanic/Latinos. Participants (n = 16,415) enrolled from March 2008 to June 2011. We describe the prevalence of minor and major ECG abnormalities and examined their cross-sectional associations with cardiovascular disease and risk factors. The Minnesota code criteria were used to define minor and major ECG abnormalities. Previous cardiovascular disease and risk factors were based on data obtained at baseline examination. Significant differences in prevalent ECG findings were found between men and women. Major ECG abnormalities were present in 9.2% (95% confidence interval 8.3 to 10.1) of men and 6.6% (95% confidence interval 5.8 to 7.3) of women (p <0.0001). The odds of having major ECG abnormalities significantly increased with age, presence of ≥3 cardiovascular risk factors, and prevalent cardiovascular disease, in both men and women. Significant differences in major ECG abnormalities were found among the varying groups; Puerto Ricans and Dominicans had more major abnormalities compared with Mexican men and women. In conclusion, in a large cohort of Hispanic/Latino men and women, prevalence of major abnormalities was low, yet strong associations of major ECG abnormalities with cardiovascular disease and risk factors were observed in both men and women.

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Methods

The HCHS/SOL is a population-based cohort study designed to examine risk and protective factors for chronic diseases and quantify morbidity and mortality prospectively. Details of the sampling methods and design have been published.24, 25, 26 Briefly, from March 2008 to June 2011, 16,415 self-identified Hispanic/Latino subjects from diverse background (Cubans, Dominicans, Mexicans, Puerto Ricans, Central Americans, and South Americans) aged 18 to 74 years were examined. Participants were

Results

Baseline characteristics of the study group are listed in Table 1. At baseline examination, men had greater prevalence of a history of hypercholesterolemia, being current smokers, having a history of heart attack and coronary revascularization; they had higher systolic and diastolic blood pressures. Women were older, more obese, and had faster heart rates.

The prevalent age-adjusted major and minor ECG abnormalities comparing men and women are listed in Table 2. Major ECG abnormalities were more

Discussion

The existing data on ECG findings are derived from largely white population.1, 3, 4, 5, 7, 8, 10, 11, 14 However, a number of studies have focused on groups with different racial backgrounds. The Strong Heart study examined ECG abnormalities among American Indians.17 The Honolulu Heart Program examined the predictive value of electrocardiogram in men of Japanese descent.18 The Evans County and Charleston Heart studies showed that African-Americans have a greater prevalence of ECG abnormalities

Acknowledgment

The authors thank the staff and participants of HCHS/SOL for their important contributions. A complete list of staff and investigators has been provided by Sorlie P et al26 and is also available on the study website http://www.cscc.unc.edu/hchs/. N.G. and D.B.G. had full access to the study data and take responsibility for the integrity of the data and accuracy of analyses. All authors have reviewed and approved the final manuscript.

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The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts N01-HC65233 from the National Heart, Lung, and Blood Institute (NHLBI), Bethesda, Maryland; N01-HC65233 to the University of North Carolina, N01-HC65234 to University of Miami, N01-HC65235 to Albert Einstein College of Medicine, N01-HC65236 to Northwestern University, and N01-HC65237 to San Diego State University. The following institutes/centers/offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements.

See page 1675 for disclosure information.

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