QRS duration predicts sudden cardiac death in hypertensive patients undergoing intensive medical therapy: The LIFE study

Morin, Daniel P., Oikarinen, Lasse, Viitasalo, Matti, Toivonen, Lauri, Nieminen, Markku S., Kjeldsen, Sverre E., Dahlof, Bjorn, John, Majnu, Devereux, Richard B. and Okin, Peter M. (2009) QRS duration predicts sudden cardiac death in hypertensive patients undergoing intensive medical therapy: The LIFE study. European Heart Journal, 30 23: 2908-2914. doi:10.1093/eurheartj/ehp321


Author Morin, Daniel P.
Oikarinen, Lasse
Viitasalo, Matti
Toivonen, Lauri
Nieminen, Markku S.
Kjeldsen, Sverre E.
Dahlof, Bjorn
John, Majnu
Devereux, Richard B.
Okin, Peter M.
Title QRS duration predicts sudden cardiac death in hypertensive patients undergoing intensive medical therapy: The LIFE study
Journal name European Heart Journal   Check publisher's open access policy
ISSN 0195-668X
1522-9645
Publication date 2009-12
Sub-type Article (original research)
DOI 10.1093/eurheartj/ehp321
Volume 30
Issue 23
Start page 2908
End page 2914
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Aims To determine whether QRS duration predicts sudden cardiac death (SCD) in patients with left ventricular hypertrophy and treated hypertension.
Methods and results Over 4.8 ± 0.9 years follow-up of 9193 hypertensive patients with electrocardiographic evidence of LVH who were treated with atenolol- or losartan-based regimens, 178 patients (1.9%) suffered SCD. In multivariable analysis including randomized treatment, changing blood pressure over time, and baseline differences between patients with and without SCD, QRS duration was independently predictive of SCD (HR per 10 ms increase = 1.22, P < 0.001). Baseline QRS duration remained a significant predictor of SCD even after controlling for the presence or absence of left bundle branch block (HR = 1.17, P = 0.001) and for changes in ECG LVH severity over the course of the study (HR = 1.16, P = 0.017).
Conclusion In the setting of aggressive antihypertensive therapy, prolonged QRS duration identifies hypertensive patients at higher risk for SCD, even after controlling for left bundle branch block, other known risk factors for SCD, and changes in blood pressure and severity of left ventricular hypertrophy.
Keyword Hypertension
Left ventricular hypertrophy
QRS duration
Sudden cardiac death
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
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