Non-specific ST-T Changes Associated With Unsatisfactory Blood Pressure Control Among Adults With Hypertension

Object:Non-specific ST-segment and T-wave(ST-T)changes represent one of the most prevalent electrocardiographic abnormalities in hypertensive patients.Recently,many studies have indicated that non-specific ST-T abnormalities are significantly associated with cardiovascular morbidity and mortality.However,few studies have investigated the association between non-specific ST-T changes and unsatisfactory blood pressure(BP)control among adults with hypertension.The goal of our study was to determine whether nonspecific baseline ST-T ECG abnormalities are associated with unsatisfactory blood pressure control in hypertensive patients,in an effort to improve the management of hypertension.Methods:The study population consisted of a total of 15038 hypertensive patients,selected from 20702 adults who had participated in the China Stroke Primary Prevention Trial(the CSPPT)and had an electrocardiogram(ECG)test performed at the baseline visit.Multiple linear regression and cox's proportional hazard regression were used for statistical analysis by Empower Stats software.1?According to the results of the ECG(defined by Minnesota coding),participants were divided into 2 groups: ST-T abnormal and ST-T normal.Baseline characteristics were compared between two groups.2?After 4.5 years follow-up period,the changes of blood pressure were compared between two groups.3?Unsatisfactory blood pressure(BP)control was defined as systolic blood pressure(SBP)?140 mmHg or diastolic blood pressure(DBP)?90 mmHg after antihypertensive treatment.The independent association between non-specific ST-T abnormalities and unsatisfactory blood pressure control was explored finally.Results:1?A total of 15038 hypertensive patients were selected for analysis.The prevalence of non-specific ST-T changes was 8.5% in rural hypertensive population,which was higher in females than males(10.3% vs 5.7%,P<0.05).2?After adjusting for covariables,the decline of systolic pressure and diastolic pressure of ST-T abnormal group were both lower than ST-T normal group([?=1.39,95%CI(0.82,1.96),P<0.001] and [?=0.50,95%CI(0.19,0.82),P=0.002] respectively).Moreover,the percentage of systolic pressure decline and diastolic pressure decline of ST-T abnormal group were both lower than ST-T normal group([?=0.80,95% CI(0.45,1.15),P<0.001] and [?=0.54,95%CI(0.20,0.88),P=0.002] respectively).3?After adjusting for covariables,the non-specific ST-T abnormal group had a significantly higher rate of unsatisfactory BP control [RR 1.20,95%CI(1.06,1.36),P=0.005],independent of traditional risk factors.Notable differences were also observed in males [RR 1.51,95%CI(1.17,1.94),P=0.002],but not in females(P>0.05).Conclusions:1?Electrocardiographic non-specific ST-T changes were common in hypertensive adults.It is more frequent in female than man.2?There are higher rates of unsatisfactory blood pressure control in hypertensive patients with electrocardiographic non-specific ST-T abnormalities,especially in males,and more intensive BP management should be put.