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A High School-Based Voluntary Cardiovascular Risk Screening Program: Issues of Feasibility and Correlates of Electrocardiographic Outcomes

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Abstract

Risk factors for adult cardiovascular events can be identified from the prenatal period through childhood. We performed a cardiovascular risk-screening program in students from grades 9–12 in 7 high schools in Hillsborough County, FL. We obtained blood pressure (BP) measurements and calculated body mass index (BMI) as risk factors for future cardiovascular events as well as obtained an electrocardiogram (ECG) for the purposes of detecting possible life-threatening arrhythmias. Of ~14,000 students contacted, 600 (4 %) participated in the screening. Of these, 517 (86 %) were diagnosed with normal, 71 (12 %) with borderline, and 12 (1 %) with abnormal ECGs. Although no participant had any cardiac history, two of the abnormal ECGs indicated a cardiac diagnosis associated with the potential for sudden cardiac death. Both systolic and diastolic BP increased as the ECG diagnosis moved from normal (115.6/73.8) through borderline (121.0/75.9) to an abnormal (125.0/80.7) diagnosis (all P ≤ .0016). An increase in BMI was only observed when an ECG diagnosis was abnormal (P = .0180). Boys had a greater prevalence (18.97 %) of borderline or abnormal ECGs compared with girls (6.75 %), whereas no discernible differences were seen in ECG diagnosis between white and nonwhite individuals (15.09 and 12.26 %, respectively). Although participation rates were low, a high school-based cardiovascular risk-screening program including ECG is feasible. Although ECG diagnosis tended to be related to other known cardiovascular risk factors (BP, BMI), the utility of an abnormal ECG in adolescence as a predictor of future cardiovascular risk will require further evaluation in more controlled settings.

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Acknowledgments

Special thanks to the Cardiac Arrhythmia Syndrome Foundation and Hillsborough County School District (Florida) for their collaboration to make this project possible.

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Authors and Affiliations

  1. All Children’s Hospital Heart Institute, St. Petersburg, FL, USA

    Gul H. Dadlani, Michael L. Epstein & Jeffrey P. Jacobs

  2. Department of Pediatrics, Miller School of Medicine, University of Miami, PO Box 016820, Miami, FL, 33101, USA

    James D. Wilkinson, David A. Ludwig, William G. Harmon, Robert O’Brien, Mary C. Sokoloski, Tracie L. Miller, Sarah E. Messiah, David C. Landy, Vivian I. Franco & Steven E. Lipshultz

  3. Department of Pediatrics, Miller School of Medicine, University of Miami, Medical Campus-MCCD-D820, 1601 NW 12th Avenue, 9th Floor, Miami, FL, 33136, USA

    Steven E. Lipshultz

Authors
  1. Gul H. Dadlani
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  2. James D. Wilkinson
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  3. David A. Ludwig
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  4. William G. Harmon
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  6. Mary C. Sokoloski
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  7. Michael L. Epstein
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  8. Tracie L. Miller
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  9. Sarah E. Messiah
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  11. Vivian I. Franco
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  12. Jeffrey P. Jacobs
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  13. Steven E. Lipshultz
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Correspondence to Steven E. Lipshultz.

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Dadlani, G.H., Wilkinson, J.D., Ludwig, D.A. et al. A High School-Based Voluntary Cardiovascular Risk Screening Program: Issues of Feasibility and Correlates of Electrocardiographic Outcomes. Pediatr Cardiol 34, 1612–1619 (2013). https://doi.org/10.1007/s00246-013-0682-8

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  • DOI: https://doi.org/10.1007/s00246-013-0682-8

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