Conventional BP was measured by one observer with a mercury sphygmomanometer with a cuff of appropriate size for the right arm of each subject after 15 minutes in a seated position. Phase V of the Korotkoff sounds was used to indicate diastolic pressure. The BP values represent the average of two determinations made two minutes apart. Automated BP was measured by the oseillometric method every eight minutes for two hours (with the Dinamap model 8455.002 monitor). This device uses a cuff that is placed around the upper arm and is inflated every eight minutes over two hours. In separate studies, we found close concordance between values obtained by the oscillometric method and simultaneous conventional mercury sphygmomanometer and intra-arterial measurements. Any automated reading that was greater than 2 SDs from the mean value was excluded as artifactual. Automated BP was obtained while the subjects were seated reading or quietly watching television. Average automated systolic and diastolic BPs were calculated by averaging the measurements obtained throughout the two-hour period. No interpolation was used.
Standard 12-lead ECGs were obtained in the supine position. P-wave duration and amplitude were measured and P-wave configuration was evaluated in ECG precordial lead V,. The P-wave was considered unimodal if it was entirely above or below the isoelectric line and was without notching. The P-wave was considered bimodal if some portion of it was above and some portion of it was below’ the baseline or if it was notched. Subjects were separated into bimodal and unimodal P-wave groups based on the P-wave configuration in V,. The ECGs were also analyzed for the presence of left ventricular hypertrophy by the Romhilt-Estes criteria and left atrial abnormality.
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