High-amplitude QRS complex in the electrocardiograms of normotensive people and risk of subsequent hypertension

Background: Left ventricular hypertrophy sometimes develops in normotensive people with a genetic background for hypertension. The aim of this case-control study was to test the hypothesis that a high-amplitude QRS complex (high-QRS) is indicative of risk of eventual hypertension. Methods: We reviewed medical charts that included blood pressure data obtained every 6 months from 7011 Japanese workers. The cases were all of 24 normotensive people showing an electrocardiogram with SV1+RV5>4.0 mV (high-QRS). The 24 controls chosen presented normal electrocardiograms and were matched for blood pressure, body mass index, age, gender, glycated hemoglobin A1c fraction, and parental occurrence of hypertension. The incidence of hypertension and change in blood pressure during a 5-year study period were compared in the two groups. Results: The cases were more likely than the controls to have a parent with hypertension (18/24 [75.0%] and 686/5704 [12.0%], respectively; P<0.01, odds RATIO=21.8 [95% CI: 8.6–55.2]). At the end of the study period, hypertension was more frequent (18/24 [75.0%] and 3/24 [12.5%], respectively; P<0.01, odds RATIO=21.0 [95% CI; 4.6–96.2]) and both systolic and diastolic blood pressures were higher (149.0±17.1 mmHg vs. 139±17.1 mmHg, P<0.01; and 89.5±9.2 mmHg vs. 81.7±11.5 mmHg, P=0.01, respectively) in the cases than in the controls. Conclusions: High-QRS may be indicative of risk of eventual hypertension, and may therefore be useful for screening purposes.