Abnormal electrocardiograms and cardiovascular risk: Role of silent myocardial ischemia: Evidence from MRFIT

doi:10.1016/0002-9149(92)90184-Z

The American Journal of Cardiology

Volume 70, Issue 16, 16 November 1992, Pages F14-F18

https://doi.org/10.1016/0002-9149(92)90184-Z Get rights and content

Abstract

The Multiple Risk Factor Intervention Trial (MRFIT) was designed as a primary prevention study to test the effect of multifactorial intervention on long-term outcome in men with a combination of risk factors that placed them in the top 10–15 percentiles of risk for coronary artery disease. Of the 12,866 patients in this study, the 3,600 men (about 28%) with abnormalities in the baseline electrocardiogram were prospectively identified. They were expected to be at increased risk for coronary events compared with those without electrocardiographic abnormalities. Analysis of cumulative mortality data following antihypertensive regimens that included high dosages of diuretics revealed an association between electrocardiographic abnormalities at rest and diuretic treatment that related to adverse outcome. When the dosages of the diuretic were lowered, this trend was reversed. It is proposed that diuretic-related hypokalemia may predispose patients who may have silent myocardial ischemia to potentially fatal arrhythmias and that use of potassium-sparing antihypertensive regimens be considered in high-risk hypertensive patients.

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Abnormal electrocardiograms and cardiovascular risk: Role of silent myocardial ischemia: Evidence from MRFIT

Abstract

Prev Med

Am J Cardiol

Am J Cardiol

Am J Med

Am Heart J

Lancet

Baseline rest electrocardiographic abnormalities, antihypertensive treatment, and mortality in the Multiple Risk Factor Intervention Trial

Am J Cardiol