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ECG abnormalities predict cardiovascular disease in older women

BMJ 2007; 334 doi: (Published 15 March 2007) Cite this as: BMJ 2007;334:559

What can an electrocardiogram (ECG) tell you about the likelihood of cardiovascular disease in apparently healthy postmenopausal women? A new study has found that women with even minor abnormalities were more likely than other women to have a heart attack, a stroke, or to die from heart disease in the next five years. Minor abnormalities included first or second degree heart block and frequent premature beats. Major abnormalities such as left or right bundle branch block were also linked to an increased risk of cardiovascular disease or death (hazard ratio 2.34, 95% CI 1.80 to 3.05).

In this cohort of more than 14 000 women, developing a new abnormality was also risky. Women who started the study with a normal ECG but developed evidence of ischaemia, atrial fibrillation or flutter, ventricular hypertrophy, abnormal excitation, or repolarisation were more than two and a half times more likely to develop clinical cardiovascular disease than women whose ECGs stayed normal.

The women were all enrolled in a placebo controlled trial of combined hormone replacement therapy (the women's health initiative), but findings from the ECG analysis were independent of any hormones they took. An ECG is a quick, cheap, and widely available source of valuable prognostic information for postmenopausal women, say the authors.


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