Major Finding: A screening of outwardly healthy high school students found that 12% had borderline ECGs and 2% had abnormal ECGs. Two had cardiac disease with the potential for sudden cardiac death, and 14% were hypertensive.
Data Source: Observational cohort study of 606 students from seven high schools in Hillsborough county in Florida.
Disclosures: Dr. Dadlani said he had no relevant financial disclosures. The study was funded by the Cardiac Arrhythmia Syndromes Foundation.
DENVER – When 606 outwardly healthy high schoolers were screened in a Florida pilot study, it turned out that 14% had borderline or abnormal electrocardiograms, 14% were hypertensive, and 12% were obese.
One student had Wolff-Parkinson-White syndrome, another left ventricular hypertrophy with strain; both carry the potential for sudden cardiac death. Hypertensive students were more likely to have evidence of end organ heart damage.
The findings reveal that “there is a significant proportion of occult disease in this community that is underrecognized, be that obesity, hypertension, or cardiac conditions,” lead author Dr. Gul H. Dadlani, a pediatric cardiologist at All Children's Hospital in St. Petersburg, Fla., said at the meeting.
However, he said that the numbers in the study are too small to argue one way or the other for universal teen ECG screening in the United States, a contentious subject pitting the cost of such a program against its potential benefits in preventing cardiovascular outcomes, especially sudden cardiac arrest.
“I think we need a national [study] to be able to” resolve that debate, he said, adding that he is working to secure funding for at least a statewide study in Florida.
The students came from seven high schools in Hillsborough county in Florida and volunteered for the screenings with their parents' consent.
Screening results were mailed to families, with follow-up care recommended as appropriate.
Body mass indexes were calculated from students' reported heights and weights. Blood pressures were taken once with a Dinamap machine.
All the students had ECGs; inverted T waves, premature ventricular contractions, prolonged QTC intervals, and right or left ventricular hypertrophy were among the findings considered abnormal.
The students' mean age was 16.5 years, and 58% were boys; 57% were white, 16% Hispanic, 12% black, 5% Asian, and the remaining students were classified as “other.”
A total of 74% had normal BMIs, 14% were overweight, and 12% were obese; 41% were normotensive, 45% were prehypertensive, and 14% were hypertensive, with hypertension most common in boys.
Hypertension and obesity were significantly associated.
Twelve percent had borderline and 2% had abnormal ECGs.
“Many of these students will go into a walk-in clinic, get their height and weight done,” a blood pressure check, and “they get signed off and cleared to participate” in sports, Dr. Dadlani commented.
If problems are caught early with more rigorous exams – including calculating age- and sex-appropriate BMIs and age-, height-, and sex-appropriate blood pressures, among other measures – “you can really make a difference in this population” by treating problems sooner, especially with the cardiovascular effects of obesity and hypertension showing up at earlier age, Dr. Dadlani explained.