ISCHEMIC EPISODES IN 24-H AMBULATORY ELECTROCARDIOGRAMS OF ELDERLY PERSONS - THE CARDIOVASCULAR HEALTH STUDY

We examined correlates of ischemic episodes in 24-h ambulatory electro cardiograms (ECG) in a sample of 1511 men and women 65 years old and o lder. Ischemic episodes had a high prevalence period during early afte rnoon and also during morning hours after awakening, and the overall p revalence was 13% in men and 9% in women (P < 0.001 for gender differe nce). The prevalence was 9.6% in participants with no history of myoca rdial infarction and no major or minor resting ECG abnormalities. In m ultivariate analysis by logistic regression, being on digitalis medica tion was associated with over a three-fold risk of ischemic episodes, with an odds ratio (95% confidence limits) of 3.21 (1.80 to 5.74). Lef t ventricular hypertrophy by ECG and atrial fibrillation had almost a three-fold excess risk of ischemic episodes, with odds ratios 2.81 (1. 37 to 5.74) and 2.63 (1.17 to 5.91), respectively. Isolated ST-T abnor malities had almost a two-fold excess of ischemic episodes, with an od ds ratio of 1.89 (1.01 to 3.54). Being overweight was associated with a 33% reduced likelihood of ischemic episodes after adjustment for oth er factors, with an odds ratio of 0.67 (0.46 to 0.98). It is concluded that the prevalence of silent ischemic episodes is high in older men and women.