Electrophysiology
Prevalence of premature ventricular contractions in a population of African American and white men and women: The Atherosclerosis Risk in Communities (ARIC) study*,**

https://doi.org/10.1067/mhj.2002.120298Get rights and content

Abstract

Background The distribution or the causes of premature ventricular contractions (PVCs) in diverse populations are not fully known. We describe the prevalence of PVCs on a 2-minute electrocardiogram (ECG) in adults to determine whether hypertension has an important association with such PVCs. Methods A cross-sectional analysis of the 15,792 individuals (aged 45-65 years) from the four US communities participating at visit 1 of the Atherosclerosis Risk In Communities (ARIC) study was performed. Multiple logistic regression was used to determine the association of PVCs with potential causal predictors of PVCs. Results Based on a 2-minute ECG, PVCs are present in >6% of middle-aged adults. Increasing age, the presence of heart disease, faster sinus rates, African American ethnicity, male sex, lower educational attainment, and lower serum magnesium or potassium levels are directly related to PVC prevalence. Independently of these factors, hypertension is associated with a 23% increase in the prevalence of PVCs. Conclusions The prevalence of PVCs on a 2-minute ECG differs by age, ethnicity, and sex and is associated with hypertension, heart disease, faster sinus rates, electrolyte abnormalities, and lower educational attainment. Hypertension is likely to be a major cause of PVCs in adults. (Am Heart J 2002;143:535-40.)

Section snippets

Methods

Data were collected during the baseline examinations of the Atherosclerosis Risk in Communities (ARIC) study. The ARIC study is a prospective cohort study investigating the etiology of atherosclerosis and the variation in cardiovascular risk factors, medical care, and disease by ethnicity, sex, place, and time. Four US communities take part in the ARIC study: Forsyth County, NC, Jackson, Miss, selected northwest suburbs of Minneapolis, Minn, and Washington County, Md. Informed consent is

Results

PVCs are present in >6% of the population, with prevalences ranging from <3% for younger white women without heart disease to approximately 20% for older, male African Americans with heart disease. The prevalence of PVCs increases with advancing age within each ethnic and sex group, so that for women the prevalence approximately doubles and for men triples from age 45 to 65 years. Similarly, heart disease is associated with an approximate doubling of the prevalence of PVCs.

The age-adjusted

Discussion

PVCs on a 2-minute ECG are common in middle-aged men and women. The prevalence of PVCs showed a strong, direct relationship to heart disease, advancing age, male sex, African American ethnicity, low educational attainment, and low serum magnesium levels. The higher prevalence seen with low educational attainment is greater than that associated with being African American, each controlled for the other and the other risk factors shown in Table IV. Low educational attainment is an important

Acknowledgements

We thank the staff and participants in the ARIC study for their important contributions.

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    *

    Supported by National Heart, Lung, and Blood Institute contracts No. N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022.

    **

    Reprint requests: Ross J. Simpson, Jr, MD, PhD, Division of Cardiology, CB#7075, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7075. E-mail: [email protected]

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