Electrocardiographic Risk Markers for Heart Failure in Women Versus Men

•Electrocardiographic (ECG) risk markers for heart failure (HF) have not been extensively studied in women.•We noticed ECG sign of left ventricular hypertrophy and HF hospitalization to be associated only in women.•In middle aged women left ventricular hypertrophy in ECG should result tightened diagnostics and prevention.•Especially adequate treatment of hypertension would have preventative value.•A yearly ECG in women with risk could have some additional value in HF prevention. Heart failure (HF) is one of the leading causes of hospitalization in the Western world. Women have a lower HF hospitalization rate and mortality compared with men. The role of electrocardiography as a risk marker of future HF in women is not well known. We studied association of electrocardiographic (ECG) risk factors for HF hospitalization in women from a large middle-aged general population with a long-term follow-up and compared the risk profile to men. Standard 12-lead ECG markers were analyzed from 10,864 subjects (49% women), and their predictive value for HF hospitalization was analyzed. During the follow-up (30 ± 11 years), a total of 1,743 subjects had HF hospitalization; of these, 861 were women (49%). Several baseline characteristics, such as age, body mass index, blood pressure, and history of previous cardiac disease predicted the occurrence of HF both in women and men (p