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Electrocardiographic Reference Values for a Population of Older Adults in Sub-Saharan Africa

Lookup NU author(s): Dr Matthew Dewhurst, Dr Luigi Di Marco, Dr Felicity DewhurstORCiD, Dr Philip Adams, Emeritus Professor Alan MurrayORCiD, Professor Richard Walker, Dr Philip Langley


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Background/ObjectivesOlder adults in sub-Saharan Africa (SSA) are at greatest risk of an impending noncommunicable diseases epidemic, of which cardiac disease is the most prevalent contributor. Thus, it is essential to establish electrocardiographic reference values for a population that is likely to differ genetically and environmentally from others where reference values are established. MethodsTwo thousand two hundred thirty-two apparently healthy community-based participants without known cardiac disease aged 70+ in rural Tanzania underwent 12-lead electrocardiography. Electrocardiograms were digitally analyzed and gender-specific reference values for P duration (P-D), P amplitude (P-AMP), P area (P-AREA), P terminal negative force (V-1) (P-TNF), PR interval, QRS duration (QRS(D)), QT/QTc, R amplitude (II, V-5) (R-AMP) LVH index (LVHI), R axis and R/S ratio (V-1) reported, following univariate analysis of covariance using a multiple linear regression model, adjusting for age, systolic blood pressure (SBP), body mass index (BMI), and RR interval. ResultsData from 1824 subjects were suitable for analysis. Adjusted mean values for men/women were: P-D 115/110 ms, P-AMP (avg) 123/114 V, P-AMP (II) 203/190 V, P-AREA (avg) 5.3/4.6 mV*s, P-AREA (II) 9.3/8.1mV*s, P-TNF 1.7/1.4 mV*s, PR 158/152 ms, QRS(D) 89/84 ms, QT 370/375 ms, QTc 421/427 ms, R-AMP (II) 805/854 V, (V-5) 2022/1742 V, LVHI 3.0/2.8 mV (Sokolow-Lyon), 1.293/1.146 mV (Cornell), R axis 51/49 degrees, R/S 0.2/0.2. Excluding P-TNF, R axis and R/S ratio, all gender differences were significant (P < 0.001 apart from LVHI [Sokolow-Lyon; P < 0.005)] and R-AMP (II) [P < 0.05]) following adjustment for age, SBP, BMI, and RR interval. ConclusionsOur description of comprehensive electrocardiographic parameters establishes reference values in this genetically and environmentally diverse SSA population thereby allowing identification of outliers with potential cardiac disease.

Publication metadata

Author(s): Dewhurst MJ, Di Marco LY, Dewhurst F, Adams PC, Murray A, Orega GP, Mwita JC, Walker RW, Langley P

Publication type: Article

Publication status: Published

Journal: Annals of Noninvasive Electrocardiology

Year: 2014

Volume: 19

Issue: 1

Pages: 34-42

Print publication date: 09/09/2013

ISSN (print): 1082-720X

ISSN (electronic): 1542-474X

Publisher: Wiley-Blackwell Publishing, Inc.


DOI: 10.1111/anec.12078


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