Background. The long-term predictive significance of a single ECG trac
ing for mortality was explored among the white and black men of the Ch
arleston Heart Study. Methods and Results. The 1960 baseline tracings
of men ages 35 to 74 in the Charleston Heart Study cohort were coded a
ccording to the Minnesota classification. Tracings were categorized as
being normal or having minor or major abnormalities. The 30-year vita
l status was ascertained for the cohort, and the association between E
CG findings and coronary and all-cause mortality was evaluated. The pr
oportion of black men with major abnormalities at the 1960 baseline ex
amination was almost twice that of white men. Rates of all-cause morta
lity increased with severity of abnormalities for white and black men.
The absolute excess risk for black men with major abnormalities was 2
3.3 per 1000 person-years and 12.8 for white men. The excess risk for
coronary mortality was 7.3 for white men and 6.5 for black men. Conclu
sions. Many of the findings in this study confirm earlier associations
derived from studies of white populations and extend the observations
to black men. However, the magnitude of the relative risk for mortali
ty was different for white and black men. After controlling for tradit
ional coronary disease risk factors and minor abnormalities, white men
with major abnormalities were 2.72 (95% confidence interval, 1.47, 5.
04) times more likely to die of coronary disease compared with black m
en, who were 1.95 (95% confidence interval, 0.93, 4.11) times more lik
ely to die of coronary disease.