title: Nonspecific ST-T changes associated with unsatisfactory blood pressure control among adults with hypertension in China: Evidence from the CSPTT study.
abstract: Nonspecific ST-segment and T-wave (ST-T) changes represent one of the most prevalent electrocardiographic abnormalities in hypertensive patients. However, a limited number of studies have investigated the association between nonspecific ST-T changes and unsatisfactory blood pressure (BP) control in adults with hypertension.The study population comprised 15,038 hypertensive patients, who were selected from 20,702 participants in the China Stroke Primary Prevention Trial. The subjects were examined with electrocardiogram test at the initial visit in order to monitor baseline heart activity. According to the results of the electrocardiogram (defined by Minnesota coding), the subjects were divided into 2 groups: ST-T abnormal and ST-T normal. Unsatisfactory BP control was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg following antihypertensive treatment during the 4.5-year follow-up period. Multivariate analysis was used to analyze the association between nonspecific ST-T abnormalities and unsatisfactory BP control.Nonspecific ST-T changes were common in hypertensive adults (approximately 8.5% in the study), and more prevalent in women (10.3%) and diabetic patients (13.9%). The unsatisfactory BP control rate was high in the total population (47.0%), notably in the ST-T abnormal group (55.5%). The nonspecific ST-T abnormal group exhibited a significantly greater rate of unsatisfactory BP control (odds ratio [OR] 1.20, 95% confidence interval [CI] [1.06, 1.36], P = 0.005]), independent of traditional risk factors, as demonstrated by multivariate regression analysis. Notable differences were further observed in male subjects (OR 1.51, 95% CI [1.17, 1.94], P = 0.002) and in patients with comorbid diabetes (OR 1.47, 95% CI [1.04, 2.07], P = 0.029).Greater rates of unsatisfactory BP control in hypertensive patients with electrocardiographic nonspecific ST-T abnormalities were observed, notably in the subcategories of the male subjects and the diabetic patients.
authors.affiliation: Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang Department of Cardiovascular Medicine, XinHua Hospital Affiliated to Shanghai Jiao Tong, University School of Medicine, Shanghai Department of Cardiology, Peking University First Hospital, Beijing National Clinical Research Study Center for Kidney Disease, State Key Laboratory for Organ, Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Huihui
authors.initials: H
authors.lastname: Bao
authors.forename: Huaxiu
authors.initials: H
authors.lastname: Cai
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Xiao
authors.initials: X
authors.lastname: Huang
authors.forename: Fangfang
authors.initials: F
authors.lastname: Fan
authors.forename: Chunyan
authors.initials: C
authors.lastname: Zhang
authors.forename: Juxiang
authors.initials: J
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Kui
authors.initials: K
authors.lastname: Hong
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Wu
authors.forename: Qinhua
authors.initials: Q
authors.lastname: Wu
authors.forename: Binyan
authors.initials: B
authors.lastname: Wang
authors.forename: Xiping
authors.initials: X
authors.lastname: Xu
authors.forename: Yigang
authors.initials: Y
authors.lastname: Li
authors.forename: Yong
authors.initials: Y
authors.lastname: Huo
authors.forename: Xiaoshu
authors.initials: X
authors.lastname: Cheng
mesh_terms: D000368:Aged; D002681:China; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged