25. CHF Risk in Hypertensive Patients
Peter Okin
Peter M. Okin, Medicine, Weill Cornell Medical College, led a study in which electrocardiogram (ECG) was found to be an effective tool for detecting risk of congestive heart failure (CHF) in patients with hypertension. An analysis of 8,696 hypertensive patients with no history of CHF found that a unique and well-known ECG wave pattern called strain was present in 923 patients (10.6 percent). These patients had a greater than threefold increased risk of developing CHF, with a five-year rate of 8.8 percent, compared with only 2.7 percent for those without ECG strain. The patients with strain also had a nearly fivefold increased risk of CHF mortality, with a five-year CHF mortality of 1.2 percent, compared with only 0.3 percent in patients without strain. The ECG strain, first identified in 1949, has previously been strongly associated with left ventricle hypertrophy (LVH) independent of coronary heart disease and with an increased risk of cardiovascular morbidity and mortality in heart patients. About 50 million Americans live with hypertension, which is controllable with treatment. These findings suggest that more aggressive therapy may be warranted in hypertensive patients with ECG strain to reduce the risk of CHF and CHF mortality. The findings may also increase early detection and treatment of CHF, a condition that affects five million Americans.