Factors of QTc interval prolongation in patients with arterial hypertension





prediction, long QT syndrome, hypertension


The relevance of determining the factors of the prolonged QTc interval development in patients with arterial hypertension is high, as it solves the issue of preliminary diagnosis among patients from risk groups and allows adjusting the diagnostic and therapeutic tactics of managing such patients.

Aim: to determine factors for the development of prolonged average daily QTc interval in patients with arterial hypertension.

Materials and methods. The study included 195 patients with arterial hypertension, who were divided into 2 subgroups: 175 individuals with a normal average daily duration of the QTc interval and 20 patients with a prolonged average daily duration of the QTc interval. All the patients underwent 24-hour heart rate monitoring and determination of blood pressure variability. At the stage of involving patients in the study, the following were performed: anamnesis collection and determination of physical data (estimation of systolic and diastolic blood pressure).

Results. The study has revealed risk factors of daily QTc interval prolongation in hypertensive patients with further developing a prognostic model with high sensitivity (88.9 %) and specificity (70.6 %). Prolongation of QTc in patients with hypertension was associated with such parameters: male sex (OR = 4.292 [95.0 % CI 1.337–13.779], Р = 0.014), body mass index (OR = 1.107 [95.0 % CI 0.987–1.243], Р = 0.083), mean 24-hour diastolic (OR = 1.076 [95.0 % CI 1.017–1.139], Р = 0.011) and pulse blood pressure (OR = 1.075 [95.0 % CІ 1.012–1.141], Р = 0.018), time since hypertension was diagnosed (OR = 1.093 [95.0 % CI 0.997–1.197], Р = 0.057) and office pulse blood pressure (OR = 0.948 [95.0 % CІ 0.900–0.999], Р = 0.046).

Conclusions. The study has determined risk factors of developing a prolonged average daily QTc interval in patients with hypertension, which will allow correcting diagnostic and treatment tactics of management for patients from risk groups.

Author Biographies

N. Ye. Tselik, V. N. Karazin Kharkiv National University, Ukraine

MD, Assistant of the Department of Internal Medicine, Medical Faculty

O. V. Bilchenko, Kharkiv Medical Academy of Postgraduate Education, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Cardiology, Therapy and Nephrology


Dzyuba, O. M., Pazynych, L. M., Sitenko, O. R., & Kryvenko, Yu. M. (2017). Shchodo pytannia hlobalnoho tiaharia khvorob v Ukraini [Regarding the issue of the global burden of diseases in Ukraine]. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorovia Ukrainy, (2), 8-13. [in Ukrainian]. https://doi.org/10.11603/1681-2786.2017.2.8101

Forouzanfar, M. H., Afshin, A., Alexander, L. T., Anderson, H. R., Bhutta, Z. A., Biryukov, S., Brauer, M., Burnett, R., Cercy, K., Charlson, F. J., Cohen, A. J., Dandona, L., Estep, K., Ferrari, A. J., Frostad, J. J., Fullman, N., Gething, P. W., Godwin, W. W., Griswold, M., … Murray, C. J. L. (2016). Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1659-1724. https://doi.org/10.1016/S0140-6736(16)31679-8

Gheorghe, A., Griffiths, U., Murphy, A., Legido-Quigley, H., Lamptey, P., & Perel, P. (2018). The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review. BMC Public Health, 18(1), 975. https://doi.org/10.1186/s12889-018-5806-x

Soenarta, A. A., Buranakitjaroen, P., Chia, Y. C., Chen, C. H., Nailes, J., Hoshide, S., Minh, H. Van, Park, S., Shin, J., Siddique, S., Sison, J., Sogunuru, G. P., Sukonthasarn, A., Tay, J. C., Teo, B. W., Turana, Y., Verma, N., Wang, T. D., Zhang, Y. Q., … Kario, K. (2020). An overview of hypertension and cardiac involvement in Asia: Focus on heart failure. Journal of Clinical Hypertension, 22(3), 423-430. https://doi.org/10.1111/jch.13753

Omar, S. M., Musa, I. R., Osman, O. E., & Adam, I. (2020). Prevalence and associated factors of hypertension among adults in Gadarif in eastern Sudan: a community-based study. BMC Public Health, 20(1), 291. https://doi.org/10.1186/s12889-020-8386-5

Di Palo, K. E. (2020). Hypertension and heart failure: focus on high-risk populations. Current Opinion in Cardiology, 35(4), 381-388. https://doi.org/10.1097/HCO.0000000000000739

Christiansen, M. N., Køber, L., Weeke, P., Vasan, R. S., Jeppesen, J. L., Smith, J. G., Gislason, G. H., Torp-Pedersen, C., & Andersson, C. (2017). Age-Specific Trends in Incidence, Mortality, and Comorbidities of Heart Failure in Denmark, 1995 to 2012. Circulation, 135(13), 1214-1223. https://doi.org/10.1161/CIRCULATIONAHA.116.025941

Wang, J., Sun, W., Wells, G. A., Li, Z., Li, T., Wu, J., Zhang, Y., Liu, Y., Li, L., Yu, Y., Liu, Y., Qi, C., Lu, Y., Liu, N., Yan, Y., Liu, L., Hui, G., & Liu, B. (2018). Differences in prevalence of hypertension and associated risk factors in urban and rural residents of the northeastern region of the People’s Republic of China: A cross-sectional study. PLOS ONE, 13(4), e0195340. https://doi.org/10.1371/journal.pone.0195340

Gumprecht, J., Domek, M., Lip, G. Y. H., & Shantsila, A. (2019). Invited review: hypertension and atrial fibrillation: epidemiology, pathophysiology, and implications for management. Journal of Human Hypertension, 33(12), 824-836. https://doi.org/10.1038/s41371-019-0279-7

Eyuboglu, M., & Acikel, B. (2022). Electrocardiographic differences in patients with true and pseudo-resistant hypertension. Journal of Human Hypertension, 36(7), 622-628. https://doi.org/10.1038/s41371-021-00559-8

Bird, K., Chan, G., Lu, H., Greeff, H., Allen, J., Abbott, D., Menon, C., Lovell, N. H., Howard, N., Chan, W.-S., Fletcher, R. R., Alian, A., Ward, R., & Elgendi, M. (2020). Assessment of Hypertension Using Clinical Electrocardiogram Features: A First-Ever Review. Frontiers in Medicine, 7. https://doi.org/10.3389/fmed.2020.583331

Ali, A., Abu Zar, M., Kamal, A., Faquih, A. E., Bhan, C., Iftikhar, W., Malik, M. B., Ahmad, M. Q., Ali, N. S., Sami, S. A., Jitidhar, F., Cheema, A. M., & Zulfiqar, A. (2018). American Heart Association High Blood Pressure Protocol 2017: A Literature Review. Cureus, 10(8), e3230. https://doi.org/10.7759/cureus.3230

Johnson, J. C., & Byrne, G. J. (2019). QT-prolonging agents with risk of torsades de pointes. Australasian Psychiatry, 27(1), 92-92. https://doi.org/10.1177/1039856218794875

Al-Akchar, M., & Siddique, M. S. (2022). Long QT Syndrome. In StatPearls. StatPearls. http://www.ncbi.nlm.nih.gov/pubmed/28722890

Morita, H., Wu, J., & Zipes, D. P. (2008). The QT syndromes: long and short. The Lancet, 372(9640), 750-763. https://doi.org/10.1016/S0140-6736(08)61307-0

Shah, S. R., Park, K., & Alweis, R. (2019). Long QT Syndrome: A Comprehensive Review of the Literature and Current Evidence. Current Problems in Cardiology, 44(3), 92-106. https://doi.org/10.1016/j.cpcardiol.2018.04.002

Breidthardt, T., Christ, M., Matti, M., Schrafl, D., Laule, K., Noveanu, M., Boldanova, T., Klima, T., Hochholzer, W., Perruchoud, A. P., & Mueller, C. (2007). QRS and QTc interval prolongation in the prediction of long-term mortality of patients with acute destabilised heart failure. Heart, 93(9), 1093-1097. https://doi.org/10.1136/hrt.2006.102319

Patel, K., Li, X., Xu, X., Sun, L., Ardissino, M., Punjabi, P., Purkayastha, S., Peters, N., Ware, J., & Ng, F. (2021). Increasing adiposity and metabolic dysfunction prolong QTc interval and increase risk of ventricular arrhythmias: results from the UK Biobank. EP Europace, 23(Suppl 3). https://doi.org/10.1093/europace/euab116.109

Sun, G. Z., Zhou, Y., Ye, N., Wu, S. J., & Sun, Y. X. (2019). Independent Influence of Blood Pressure on QTc Interval: Results from a General Chinese Population. BioMed Research International, 2019, 1656123. https://doi.org/10.1155/2019/1656123

Yılmaz, A. S., Çinier, G., Çırakoğlu, Ö. F., & Çetin, M. (2021). Epicardial adipose tissue predicted prolonged QTc interval in patients with arterial hypertension. Clinical and Experimental Hypertension, 43(3), 230-236. https://doi.org/10.1080/10641963.2020.1847131

Yan, L., Jin, J., Jiang, S., Zhu, W., Gao, M., Zhao, X., & Yuan, J. (2020). QTc interval predicts disturbed circadian blood pressure variation. Open Medicine, 15(1), 139-146. https://doi.org/10.1515/med-2020-0021

Rich, J. D., Thenappan, T., Freed, B., Patel, A. R., Thisted, R. A., Childers, R., & Archer, S. L. (2013). QTc prolongation is associated with impaired right ventricular function and predicts mortality in pulmonary hypertension. International Journal of Cardiology, 167(3), 669-676. https://doi.org/10.1016/j.ijcard.2012.03.071



How to Cite

Tselik NY, Bilchenko OV. Factors of QTc interval prolongation in patients with arterial hypertension. Zaporozhye Medical Journal [Internet]. 2023Feb.15 [cited 2024Jul.20];25(1):5-10. Available from: http://zmj.zsmu.edu.ua/article/view/262450