Published: 2020-03-26

The ECG changes in various comorbidities with hypertension and without hypertension

Metta Anil Kumar, J. Muralikrishna, Anand Acharya


Background: Hypertension is the commonest cardiovascular disorder posing a challenge to the societies in socioeconomic and epidemiologic transition. In India, Cardiovascular Diseases (CVDs) are estimated to be responsible for 1.5 million deaths annually. Indeed, it is estimated that by 2020, CVDs will be the largest cause of mortality and morbidity in India. To present study is designed to evaluate the variation of blood pressure and ECG wave forms among people hypertension with co morbidities (study group) and controls.

Methods: The study included 50 people comorbidities with hypertension and 50 controls, each between ages 30-40 years from general population, and also from Medicine outpatient department, KIMS and RF Amalapuram. Detailed history from subjects, blood pressure (sitting position) and electrocardiogram was recorded during resting state in supine position. The ECG results were evaluated for various parameters like heart rate, P wave, PR interval, QRS complex etc.

Results: There was significant increase in heart rate, systolic blood pressure as well as diastolic blood pressure in study group when compared to controls. Decrease in PR interval, decrease in QT interval, decrease in QTc interval, decrease in QRS axis in smokers when compared to controls.

Conclusions: There was significant increase in heart rate in study group (smokers, diabetic) when compared to controls. There was significant increase in systolic blood pressure as well as diastolic blood pressure in study group (smokers, diabetics) when compared to controls. There was significant decrease in PR interval in smokers when compared to controls. There was significant decrease in QT and QTc interval in smokers when compared to controls.


Diabetes, ECG, Hypertension, Smoker

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Hoeger WWK, Hoeger SA. Lifestyle as health problem. In: Pople L, Lustig A, Arvin S, Chiapella K editors. Lifetime Physical Fitness and Wellbeing, APersonalized Program. 2 Ed. United States: Englewood Colarado Mortannd Publication; 1989:1-33.

WHO, Hypertension Control: Report of a WHOexpert committee. WHO Technical Report SeriesNo 862, World Health Organisation, Geneva, 1996, Available at: Accessed 14 December 2019.

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005 Jan 15;365(9455):217-23.

Novo S, Lunetta M, Evola S, Novo G. Role of ARBs in the blood hypertension therapy and prevention of cardiovascular events. Curr Drug Targets. 2009 Jan 1;10(1):20-5.

Yusuf S, Reddy S, Ôunpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001 Nov 27;104(22):2746-53.

The World Health Report 2008: Primary Health Care - Now More Than Ever. Geneva, Switzerland: World Health Organization; 2008. World Health Organization. Available at; Accessed 21 December 2019.

Horton R, Das P. Indian health: the path from crisis to progress. Lancet. 2011 Jan 15;377(9761):181-3.

Balarajan Y, Selvaraj S, Subramanian SV. Health care and equity in India. Lancet. 2011 Feb 5;377(9764):505-15.

Gaziano T, Reddy KS, Paccaud F, Horton S, Chaturvedi V. Cardiovascular disease. In: Jamison DT, Mosley WH, eds. Disease Control Priorities in the Developing World. Oxford: Oxford University Press; 2006:645–662.

The World Health Report 2002: Reducing Risk, Promoting Healthy Life. Geneva, Switzerland: World Health Organization; 2002. World Health Organization. Available at: Accessed 24 December 2019.

Venkatesh G, Swamy RM. A Study of Electrocardiographic changes in Smokers compared to normal human beings. Biomedical Res 2010;21(4):389-92.

Fenton RA, Dobson Jr JG. Nicotine increases heart adenosine release, oxygen consumption, and contractility. Am J Physiol-Heart Circul Physiol. 1985 Sep 1;249(3):H463-9.

McKenna WJ, Chew CY, Oakley CM. Myocardial infarction with normal coronary angiogram. Possible mechanism of smoking risk in coronary artery disease. Heart. 1980 May 1;43(5):493-8.

Levine PH. An acute effect of cigarette smoking on platelet function: a possible link between smoking and arterial thrombosis. Circulation. 1973 Sep;48(3):619-23.

Sharma SB, Dwivedi S, Prabhu KM, Singh G, Kumar N, Lal MK. Coronary risk variables in young asymptomatic smokers. Ind J Med Res. 2005 Sep 1;122(3):205.

Hermida RC, Ayala DE, Calvo C, Covelo M, Rodriguez M, et al. Influence of cigarette smoking on ambulatory blood pressure in patients with essential hypertension. Am J Hypertens. 2005;18:33.

Khoury Z, Comans P, Keren A, Lerer T, Gavish A, Tzivoni D. Effects of transdermal nicotine patches on ambulatory ECG monitoring findings: a double-blind study in healthy smokers. Cardio Drugs Therapy. 1996 Oct 1;10(2):179-84.

Khan IS, Rahman MA, Amin R. Study of ECG changes in Apparently Healthy Adult Male Smokers. Dinajpur Med Col J. 2011Jan;4(1):7-14.

Ewing DJ, Boland O, Neilson JMM, Cho CG, Clarke BF. Autonomic neuropathy, QT interval lengthening and unexpected deaths in male diabetic patients. Diabtologia. 1991;34:182-85.