Determinants Influencing the Electrocardiographic Diagnosis of Left Ventricular Hypertrophy Among Hypertensive Patients

Aims and objectives The present study aimed to evaluate the utility of electrocardiography (ECG) in diagnosing left ventricular hypertrophy (LVH) among hypertensive patients and to compare the diagnostic performance of Cornell voltage product (CVP) and Sokolow-Lyon criteria (SLC) across various demographic and clinical subgroups like age, sex, body mass index (BMI), diabetes, smoking, and alcohol use. The present study was conducted in an Indian population due to the lack of existing studies regarding this topic. Methodology The present study is a cross-sectional study conducted at Rajiv Gandhi Government General Hospital, Chennai, involving 544 hypertensive patients divided into "only ECG-positive," "only ECHO-positive," and "both ECHO and ECG-positive" groups. Baseline demographic and clinical data were collected. ECG findings using CVP and SLC were compared with ECHO findings, and statistical analyses were utilized to assess diagnostic sensitivity and subgroup variations. Results Older age and male gender were associated with higher diagnostic sensitivity for LVH, while diabetes and obesity were found to reduce sensitivity. Notably, chronic alcohol use emerged as a positive determinant of LVH detection. CVP was more effective in detecting LVH among females, overweight individuals, and alcohol users, whereas SLC was more sensitive among males, smokers, and diabetics. Conclusions ECG demonstrates significant potential as a screening tool for LVH in resource-limited settings, particularly when tailored to specific demographic and clinical subgroups. The differential performance of CVP and SLC underscores the importance of personalized diagnostic approaches. Further large-scale studies are needed to validate these findings and optimize the use of ECG for LVH diagnosis in diverse populations.