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Circulation. 1960;21:1160-1175

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(Circulation. 1960;21:1160.)
© 1960 American Heart Association, Inc.

The Electrocardiogram in Population Studies

A Classification System

HENRY BLACKBURN M.D.1; ANCEL KEYS PH.D.1; ERNST SIMONSON M.D.1; PENTTI RAUTAHARJU M.D.1; SVEN PUNSAR M.D.1

1 From the Laboratory of Physiological Hygiene, University of Minnesota, Minneapolis, Minn.

Information now available about the prevalence and incidence of coronary heart disease is seriously deficient because of the lack of standardized and objective methods of collection, tabulation, interpretation, and reporting of survey data. Chief reliance in the objective diagnosis of coronary heart disease rests on the electrocardiogram, a crucial tool in population studies. A classification system for the electrocardiogram in epidemiologic studies has been developed, tested, and herein presented. It is adapted to the usual clinical reading technics of the electrocardiographer. It embodies criteria widely employed and of diagnostic and prognostic import, but no stipulations about interpretation are made. The system permits more valid comparisons of data on heart disease between populations. It is susceptible to modern methods of data processing.




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 Arterioscler. Thromb. Vasc. Bio.Home page
R. P. Tracy, B. M. Psaty, E. Macy, E. G. Bovill, M. Cushman, E. S. Cornell, and L. H. Kuller
Lifetime Smoking Exposure Affects the Association of C-Reactive Protein with Cardiovascular Disease Risk Factors and Subclinical Disease in Healthy Elderly Subjects
Arterioscler Thromb Vasc Biol, October 1, 1997; 17(10): 2167 - 2176.
[Abstract] [Full Text]

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 StrokeHome page
R. Schmidt, H. Schmidt, F. Fazekas, M. Schumacher, K. Niederkorn, P. Kapeller, V. Weinrauch, and G. M. Kostner
Apolipoprotein E Polymorphism and Silent Microangiopathy-Related Cerebral Damage : Results of the Austrian Stroke Prevention Study
Stroke, May 1, 1997; 28(5): 951 - 956.
[Abstract] [Full Text]

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 HypertensionHome page
J. M. Gardin, A. Arnold, J. S. Gottdiener, N. D. Wong, L. P. Fried, H. S. Klopfenstein, D. H. O'Leary, R. Tracy, and R. Kronmal
Left Ventricular Mass in the Elderly : The Cardiovascular Health Study
Hypertension, May 1, 1997; 29(5): 1095 - 1103.
[Abstract] [Full Text]

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 Arch Intern MedHome page
D. Hasdai, P. B. Berger, M. R. Bell, C. S. Rihal, K. N. Garratt, and D. R. Holmes Jr
The Changing Face of Coronary Interventional Practice: The Mayo Clinic Experience
Arch Intern Med, March 24, 1997; 157(6): 677 - 682.
[Abstract] [PDF]

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 BMJHome page
M.-A. Gall, P. Hougaard, K. Borch-Johnsen, and H.-H. Parving
Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study
BMJ, March 15, 1997; 314(7083): 783 - 783.
[Abstract] [Full Text]

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 NEJMHome page
D. Hasdai, K. N. Garratt, D. E. Grill, A. Lerman, and D. R. Holmes
Effect of Smoking Status on the Long-Term Outcome after Successful Percutaneous Coronary Revascularization
N. Engl. J. Med., March 13, 1997; 336(11): 755 - 761.
[Abstract] [Full Text] [PDF]

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 Ann. Thorac. Surg.Home page
J. H. Lemmer Jr, E. W. Dilling, J. R. Morton, J. B. Rich, F. Robicsek, D. L. Bricker, C. B. Hantler, J. G. Copeland III, J. L. Ochsner, P. O. Daily, et al.
Aprotinin for Primary Coronary Artery Bypass Grafting: A Multicenter Trial of Three Dose Regimens
Ann. Thorac. Surg., December 1, 1996; 62(6): 1659 - 1668.
[Abstract] [Full Text]

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 J. Thorac. Cardiovasc. Surg.Home page
O. Tasdemir, U. Kiziltepe, H. Y. Karagoz, B. Yamak, S. Korkmaz, and K. Bayazit
LONG-TERM RESULTS OF RECONSTRUCTIONS OF THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN DIFFUSE ATHEROSCLEROTIC LESIONS
J. Thorac. Cardiovasc. Surg., September 1, 1996; 112(3): 745 - 754.
[Abstract] [Full Text]

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 Arterioscler. Thromb. Vasc. Bio.Home page
M. Cushman, B. M. Psaty, E. Macy, E. G. Bovill, E. S. Cornell, L. H. Kuller, and R. P. Tracy
Correlates of Thrombin Markers in an Elderly Cohort Free of Clinical Cardiovascular Disease
Arterioscler Thromb Vasc Biol, September 1, 1996; 16(9): 1163 - 1169.
[Abstract] [Full Text]

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 HypertensionHome page
P. M. Rautaharju, T. A. Manolio, D. Siscovick, S. H. Zhou, J. M. Gardin, R. Kronmal, C. D. Furberg, N. O. Borhani, and A. Newman
Utility of New Electrocardiographic Models for Left Ventricular Mass in Older Adults
Hypertension, July 1, 1996; 28(1): 8 - 15.
[Abstract] [Full Text]

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 CirculationHome page
P. W. Serruys, H. Emanuelsson, W. van der Giessen, A. C. Lunn, F. Kiemeney, C. Macaya, W. Rutsch, G. Heyndrickx, H. Suryapranata, V. Legrand, et al.
Heparin-Coated Palmaz-Schatz Stents in Human Coronary Arteries : Early Outcome of the Benestent-II Pilot Study
Circulation, February 1, 1996; 93(3): 412 - 422.
[Abstract] [Full Text]

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 CirculationHome page
E. Camenzind, P.-P. Kint, C. Di Mario, J. Ligthart, W. van der Giessen, E. Boersma, and P. W. Serruys
Intracoronary Heparin Delivery in Humans : Acute Feasibility and Long-term Results
Circulation, November 1, 1995; 92(9): 2463 - 2472.
[Abstract] [Full Text]

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 CirculationHome page
J. H. Levy, R. Pifarre, H. V. Schaff, J. C. Horrow, R. Albus, B. Spiess, T. K. Rosengart, J. Murray, R. E. Clark, P. Smith, et al.
A Multicenter, Double-Blind, Placebo-Controlled Trial of Aprotinin for Reducing Blood Loss and the Requirement for Donor-Blood Transfusion in Patients Undergoing Repeat Coronary Artery Bypass Grafting
Circulation, October 15, 1995; 92(8): 2236 - 2244.
[Abstract] [Full Text]

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 NEJMHome page
P. W. Serruys, J.-P. R. Herrman, R. Simon, W. Rutsch, C. Bode, G.-J. Laarman, R. van Dijk, A. A. van den Bos, V. A.W.M. Umans, K. A.A. Fox, et al.
A Comparison of Hirudin with Heparin in the Prevention of Restenosis after Coronary Angioplasty
N. Engl. J. Med., September 21, 1995; 333(12): 757 - 764.
[Abstract] [Full Text] [PDF]

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 Arch NeurolHome page
R. Schmidt, F. Fazekas, M. Koch, P. Kapeller, M. Augustin, H. Offenbacher, G. Fazekas, and H. Lechner
Magnetic Resonance Imaging Cerebral Abnormalities and Neuropsychologic Test Performance in Elderly Hypertensive Subjects: A Case-Control Study
Arch Neurol, September 1, 1995; 52(9): 905 - 910.
[Abstract] [PDF]

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 StrokeHome page
J. Willeit, S. Kiechl, P. Santer, F. Oberhollenzer, G. Egger, E. Jarosch, and A. Mair
Lipoprotein(a) and Asymptomatic Carotid Artery Disease : Evidence of a Prominent Role in the Evolution of Advanced Carotid Plaques: The Bruneck Study
Stroke, September 1, 1995; 26(9): 1582 - 1587.
[Abstract] [Full Text]

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 NEJMHome page
P. W. Serruys, P. de Jaegere, F. Kiemeneij, C. Macaya, W. Rutsch, G. Heyndrickx, H. Emanuelsson, J. Marco, V. Legrand, P. Materne, et al.
A Comparison of Balloon-Expandable-Stent Implantation with Balloon Angioplasty in Patients with Coronary Artery Disease
N. Engl. J. Med., August 25, 1994; 331(8): 489 - 495.
[Abstract] [Full Text]

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 NEJMHome page
D. S. Siscovick, T.E. Raghunathan, B. M. Psaty, T. D. Koepsell, K. G. Wicklund, X. Lin, L. Cobb, P. M. Rautaharju, M. K. Copass, and E. H. Wagner
Diuretic Therapy for Hypertension and the Risk of Primary Cardiac Arrest
N. Engl. J. Med., June 30, 1994; 330(26): 1852 - 1857.
[Abstract] [Full Text]

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 JAMAHome page
M. Hollenberg, D. T. Mangano, W. S. Browner, M. J. London, J. F. Tubau, I. M. Tateo, the Study of Perioperative Ischemia Research Group, D. T. Mangano, W. S. Browner, M. Hollenberg, et al.
Predictors of Postoperative Myocardial Ischemia in Patients Undergoing Noncardiac Surgery
JAMA, July 8, 1992; 268(2): 205 - 209.
[Abstract] [PDF]

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 JAMAHome page
M. J. Eisenberg, M. J. London, J. M. Leung, W. S. Browner, M. Hollenberg, J. F. Tubau, I. M. Tateo, N. B. Schiller, D. T. Mangano, the Study of Perioperative Ischemia Research Group, et al.
Monitoring for Myocardial Ischemia During Noncardiac Surgery: A Technology Assessment of Transesophageal Echocardiography and 12-Lead Electrocardiography
JAMA, July 8, 1992; 268(2): 210 - 216.
[Abstract] [PDF]

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 JAMAHome page
B. O'Kelly, W. S. Browner, B. Massie, J. Tubau, L. Ngo, D. T. Mangano, the Study of Perioperative Ischemia Research Group, D. T. Mangano, M. J. London, W. S. Browner, et al.
Ventricular Arrhythmias in Patients Undergoing Noncardiac Surgery
JAMA, July 8, 1992; 268(2): 217 - 221.
[Abstract] [PDF]

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 JAMAHome page
W. S. Browner, J. Li, D. T. Mangano, Study of Perioperative Ischemia Research Group, D. T. Mangano, W. S. Browner, M. Hollenberg, J. F. Tubau, J. M. Leung, W. C. Krupski, et al.
In-Hospital and Long-term Mortality in Male Veterans Following Noncardiac Surgery
JAMA, July 8, 1992; 268(2): 228 - 232.
[Abstract] [PDF]

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 JAMAHome page
D. T. Mangano, W. S. Browner, M. Hollenberg, J. Li, I. M. Tateo, Study of Perioperative Ischemia Research Group, D. T. Mangano, M. J. London, W. S. Browner, M. Hollenberg, et al.
Long-term Cardiac Prognosis Following Noncardiac Surgery
JAMA, July 8, 1992; 268(2): 233 - 239.
[Abstract] [PDF]

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 ANN INTERN MEDHome page
T. A. Manolio, C. D. Furberg, P. W. Wahl, R. P. Tracy, N. O. Borhani, J. M. Gardin, L. P. Fried, D. H. O'Leary, and L. H. Kuller
Eligibility for Cholesterol Referral in Community-dwelling Older Adults: The Cardiovascular Health Study
Ann Intern Med, April 15, 1992; 116(8): 641 - 649.
[Abstract] [PDF]

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 ANGIOLOGYHome page
S. R. Johansson, M. Sanez, and H. Emanuelsson
Transient Myocardial Ischemia During Holter Registration Before and After Coronary Angioplasty
Angiology, June 1, 1991; 42(6): 429 - 440.
[Abstract] [PDF]

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 ANGIOLOGYHome page
S. R. Johansson, L. Ekstrom, and H. Emanuelsson
Higher Recurrence Rate After Coronary Angioplasty in Unstable Angina Pectoris
Angiology, April 1, 1991; 42(4): 273 - 280.
[Abstract] [PDF]

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 JAMAHome page
Lipid Research Clinics Program
The Lipid Research Clinics Coronary Primary Prevention Trial Results: I. Reduction in Incidence of Coronary Heart Disease
JAMA, January 20, 1984; 251(3): 351 - 364.
[Abstract] [PDF]

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 Arch Intern MedHome page
M. A. Codini, N. T. Ruggie, M. D. Goldin, J. V. Messer, and H. Najafi
Diaphragmatic Left Ventricular Aneurysm: Clinical Features, Surgical Treatment, and Long-term Follow-up in 22 Patients
Arch Intern Med, April 1, 1982; 142(4): 711 - 714.
[Abstract] [PDF]

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 JAMAHome page
G. L. Knatterud, C. R. Klimt, M. E. Levin, M. E. Jacobson, and M. G. Goldner
Effects of Hypoglycemic Agents on Vascular Complications in Patients With Adult-Onset Diabetes: VII. Mortality and Selected Nonfatal Events With Insulin Treatment
JAMA, July 7, 1978; 240(1): 37 - 42.
[Abstract] [PDF]

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 Arch Intern MedHome page
A. B. Weisse, P. D. Abiuso, and I. S. Thind
Acute Myocardial Infarction in Newark, NJ: A Study of Racial Incidence
Arch Intern Med, October 1, 1977; 137(10): 1402 - 1405.
[Abstract] [PDF]

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 JAMAHome page
R. F. Bradley, H. Dolger, P. H. Forsham, and H. Seltzer
"Settling the UGDP Controversy"?
JAMA, May 26, 1975; 232(8): 813 - 817.
[Abstract] [PDF]


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