Racial variation in ECGs

Published: 20 July 2020

Normal ECG appearances vary in different racial groups. The ECG Core Lab, based in Glasgow Royal Infirmary, continues to ensure that diagnostic criteria for ECG interpretation acknowledge this fact

The ECG Core Lab, based in Glasgow Royal Infirmary, has had a long-standing interest in looking at the effects of race on ECG appearances. For this reason, collaborations have been established over the years that have allowed ECGs to be recorded from healthy volunteers initially in Taiwan, then in India and more recently in Nigeria.

Volunteers queue for ECG recordings in Ilorin NigeriaCollaborators from these countries have visited Glasgow at various times and Professor Peter Macfarlane has made reciprocal visits to further these studies. Indeed, Dr I. Katibi, now Professor Katibi, obtained his MD from Glasgow for his work on the normal limits of the ECG in healthy Nigerians. In addition, the Glasgow automated ECG analysis program has been used for analysis of ECGs from other countries such as Angola and Brazil, where almost half a million ECGs were analysed to determine normal limits.

These studies have shown that black people tend to have higher ECG voltages compared to other racial groups including white people, while the opposite is true for Chinese people. ECG criteria for a heart attack can also be optimised for race.

Thus, the Core Lab recognised the importance of acknowledging racial variation over 30 years ago and still continues to ensure that diagnostic criteria for ECG interpretation acknowledge this fact.

Peter Macfarlane
Emeritus Professor/Honorary Senior Research Fellow
ECG Core Lab 
Robertson Centre for Biostatistics 
Glasgow Royal Infirmary


First published: 20 July 2020