Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2001 Sep;24(9):597-602.
doi: 10.1002/clc.4960240906.

Effect of ethnicity and hypertension on atrial conduction: evaluation with high-resolution P-wave signal averaging

E C Madu  1 , D S Baugh, T D Gbadebo, A Dhala, S Cardoso; Phi-Res Multi-Study Group
Affiliations
Comparative Study

Effect of ethnicity and hypertension on atrial conduction: evaluation with high-resolution P-wave signal averaging

E C Madu et al. Clin Cardiol. 2001 Sep.

Abstract

Background: Measurements by P-wave signal-averaged electrocardiogram (P-SAECG) of P-wave duration and P-wave voltage integral are higher in patients with atrial fibrillation (AF) than in those with sinus rhythm. Hypertension is perhaps the most common cardiovascular antecedent cause of AF, and particularly a disproportionate cause of morbidity and mortality among blacks. The purpose of this study was to examine the effect of hypertension and ethnicity on P-SAECG parameters in patients without AF.

Hypothesis: It was hypothesized that P-SAECG parameters can identify hypertensives, and are disproportionately higher in hypertensive blacks.

Methods: In all, 234 normotensives and 84 hypertensives underwent P-SAECG analysis. In an ancillary study group of 34 hypertensive black men, the relationship between severity of hypertension and measured parameters of P-SAECG was evaluated.

Results: Mean filtered P-wave duration and total P-wave voltage integral for normotensives of both ethnic groups were similar. Hypertensive blacks had greater increase in P-wave duration (138 +/- 16 vs. 132 +/- 12ms;p < 0.01, N42:42) and total P-wave voltage integral (922 +/- 285 vs. 764 +/- 198 microV-ms; p < 0.001) than white hypertensives. Filtered P-wave duration and total P-wave voltage integral increased with severity of hypertension.

Conclusions: Patients at very early stages of hypertension have demonstrable evidence of prolonged atrial conduction by P-SAECG and, thus, cardiac electrical remodeling. P-wave duration and total P-wave voltage integral increase with severity of hypertension. Hypertensive blacks manifest a greater increase in P-SAECG parameters than whites. This may portend an increased cardiovascular risk for black patients with hypertension.

PubMed Disclaimer

References

    1. Guidera SA, Steinberg JS: The signal averaged P‐wave duration, a rapid and noninvasive marker of risk of atrial fibrillation. J Am Coll Cardiol 1993; 21: 1645–1651 - PubMed
    1. Fukunami M, Yamada T, Ohmori M, Kumagai K, Umemoto K, Sakai A, Kondoh N, Minamino T, Hoki N: Detection of patients at risk for paroxysmal atrial fibrillation during sinus rhythm by P‐wave‐triggered signal‐averaged electrocardiogram. Circulation 1991; 83: 162–169 - PubMed
    1. Stafford PJ, Turner I, Vincent R: Quantitative analysis of signal‐averaged P waves in idiopathic paroxysmal atrial fibrillation. Am J Cardiol 1991; 68: 751–755 - PubMed
    1. Opolski G, Stanislawska J, Stomka K, Kraska T: Value of the atrial signal‐averaged electrocardiogram in identifying patients with paroxysmal atrial fibrillation. Int J Cardiol 1991;30:315–319 - PubMed
    1. Gondo N, Kumagai K, Matsuo K, Ogawa M, Annoura M, Moroe K, Arakawa K: The best criterion for discrimination between patients with and without paroxysmal atrial fibrillation on signal‐averaged electrocardiogram. Am J Cardiol 1995;75:93–95 - PubMed

Publication types