Baseline prevalence of left ventricular hypertrophy and other electrocardiographic anomalies and their associated factors among adults aged 20 to 24 and 35 to 39 years in rural eastern Uganda

Background Cardiovascular diseases are the leading cause of death worldwide and are rising in sub-Saharan Africa, where they tend to occur at younger ages than in high-income countries. Left ventricular hypertrophy (LVH) is an early marker of hypertension-related cardiac strain, but its background level in young rural African populations is not well described. Objective To determine the prevalence of LVH and other electrocardiographic (ECG) anomalies, and the factors associated with them, among young people in rural eastern Uganda. Methods A cross-sectional survey was nested in a feasibility cohort at the Iganga-Mayuge Health and Demographic Surveillance Site, as part of its baseline data collection. The feasibility cohort targets to follow up a sample of people aged 20–24 and 35–39 years for five years, to determine changes in their risk profile and the practicality of setting up of a long-term cohort. Of 520 sampled adults aged 20–24 and 35–39 years, 377 underwent a 12-lead ECG read by a specialist cardiologist. Modified Poisson regression with robust standard errors estimated adjusted prevalence ratios (APR) for factors associated with abnormal ECG findings. They also underwent baseline assessments for socio-demographic factors, lifestyle (tobacco and alcohol use, dietary diversity, physical activity), BMI, waist circumference, apolipoproteins A and B, blood pressure and Fasting Plasma Glucose, all classified using standard criteria. Results The prevalence of abnormal ECG findings was 7.2% (27/377), with no significant difference between the 20–24 (7.7%) and 35–39 (6.3%) year age groups (p = 0.609). LVH was the commonest anomaly (5.3%). Only current alcohol use was independently associated with an abnormal ECG (APR 3.6; 95% CI 1.21–10.48; p = 0.021). Hypertension, tobacco use, elevated body mass index, apolipoprotein B and fasting glucose showed no significant association with abnormal ECG status. Family history of cardiovascular disease had a marginal association (APR 2.0; 95% CI 0.94–4.18; p = 0.073). Conclusion Abnormal ECG/LVH prevalence in this relatively young rural population was modest and was not associated with hypertension, suggesting a largely physiological pattern. The alcohol association warrants cautious interpretation and further study.