Independent risk for cardiovascular disease predicted by modified continuous score electrocardiographic criteria for 6-year incidence and regression of left ventricular hypertrophy among clinically disease free men: 16-year follow-up for the multiple risk factor intervention trial

Risk prediction for electrocardiographic (ECG) left ventricular hypertrophy related criteria, used in clinical trials, and epidemiologic studies of cl inically healthy people, has depended in the Fast on dichotomous classifica tion of ECG LVH criteria. Recent analyses have shown that more sensitive me thods of LVH ECG classification without loss of specificity are needed to i mprove on dichotomous classification. This was done by relating six year in cident significant change in continuous score criteria of ECG LVH to the 16 year (10 year post trial) coronary heart disease (CHD) and cardiovascular disease (CVD) mortality among 12,866 men, free of clinical disease, aged 35 to 57 years at baseline in the Multiple Risk Factor Intervention Trial. It was found that significant change in continuous ECG LVH criteria T was a s tronger independent predictor of future CHD and CVD mortality than was use of dichotomous classification of the same criteria. It was also demonstrate d that increase in continuous ECG LVH indexes, below previous dichotomous t hresholds independently (of standard CVD risk factors, including increase i n obesity-indicated by an increase in adult BR II) predicted excess CHD and CVD mortality and that combinations of continuous indices increases the sp ecificity and relative risk in clinically disease-free middle-aged men.