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Lessons from reporting 100,000 Jamaican electrocardiograms.

The screening programme of the Heart Foundation of Jamaica has found hypertension in 71% of women and 47% of men. Of these patients, 13% were newly discovered hypertensives. Left ventricular hypertrophy was present in 18% of hypertensive women and in 27% of men. Inadequate control of raised blood pressure was a frequent finding. Ischaemic electrocardiographic (ECG) changes were only found in 4% of the 14,739 patients seen in the past two years but this is an underestimation of the prevalence of ischaemic heart disease. Arrhythmias seen over 15 years were usually benign, of sinus origin or ectopics in the absence of heart disease. Uncontrolled atrial fibrillation remains the most serious arrhythmia encountered and usually in hypertensive patients. Obesity found in 80% of women is a problem requiring public education. 'Silent' ischaemia in diabetic and left ventricular hypertrophy in hypertensive patients indicate the need for ECG examination in all newly diagnosed patients with either condition, and annual ECGs thereafter.