Electrocardiogram screening for left high R-wave predicts cardiovascular death in a Japanese community-based population: NIPPON DATA90

Koshi Nakamura, Tomonori Okamura, Takehito Hayakawa, Takashi Kadowaki, Yoshikuni Kita, Akira Okayama, Hirotsugu Ueshima, Osamu Iimura, Teruo Omae, Kazuo Ueda, Hiroshi Yanagawa, Hiroshi Horibe, Kazunori Kodama, Fumiyoshi Kasagi, Shinichi Tanihara, Shigeyuki Saito, Kiyomi Sakata, Yoshikazu Nakamura, Fumihiko Kakuno, Toshihiro TakeuchiMitsuru Hasebe, Fumitsugu Kusuno, Takahisa Kawamoto, Masumi Minowa, Minoru Iida, Tsutomu Hashimoto, Shigemichi Tanaka, Atsushi Terao, Katsuhiko Kawaminami, Koryo Sawai, Shigeo Shibata

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Little is known about the efficacy of left ventricular hypertrophy diagnosed by electrocardiography for predicting cardiovascular disease in a general Japanese population. In a large cohort of participants selected randomly from the overall Japanese population, we attempted to evaluate the usefulness of a high amplitude R-wave (left high R-wave) on the electrocardiogram for predicting cardiovascular death. A total of 6,688 Japanese (mean age, 50.7 years old; 57% women) free of previous cardiovascular disease and use of antihypertensive agents at baseline were followed for 10 years, from 1990 to 2000. Left high R-wave on the electrocardiogram (the Minnesota Code, 3-1 or 3-3) was found in 9.4% of the 6,688 participants, in 14.6% of the 2,413 hypertensives and in 4.1% of the 4,275 normotensives. During the follow-up period, 128 participants died due to cardiovascular disease. After adjustment for systolic blood pressure and other risk factors, left high R-wave conferred an increased risk of cardiovascular death; the hazard ratio among all the participants was 1.88 (95% confidence interval, 1.22-2.89; p<0.01), that among hypertensives was 1.97 (1.20-3.24; p=0.01), and that among normotensives was 1.66 (0.69-3.98; p=0.26). The population attributable risk percent of left high R-wave for cardiovascular death was 7.6% among all participants, 12.4% among hypertensives and 4.1% among normotensives. Left high R-wave on electrocardiogram, irrespective of the level of systolic blood pressure, was a predictive marker for cardiovascular death among community-dwelling Japanese.

Original languageEnglish
Pages (from-to)353-360
Number of pages8
JournalHypertension Research
Volume29
Issue number5
DOIs
Publication statusPublished - 2006 May

Keywords

  • Cardiovascular disease
  • Electrocardiogram
  • High amplitude R-wave (lef high R-wave)
  • Left ventricular hypertrophy
  • The Minnesota code

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Nakamura, K., Okamura, T., Hayakawa, T., Kadowaki, T., Kita, Y., Okayama, A., Ueshima, H., Iimura, O., Omae, T., Ueda, K., Yanagawa, H., Horibe, H., Kodama, K., Kasagi, F., Tanihara, S., Saito, S., Sakata, K., Nakamura, Y., Kakuno, F., ... Shibata, S. (2006). Electrocardiogram screening for left high R-wave predicts cardiovascular death in a Japanese community-based population: NIPPON DATA90. Hypertension Research, 29(5), 353-360. https://doi.org/10.1291/hypres.29.353