A Review of Racial Differences and Disparities in ECG

Authors

Jianwei Zheng, Charles R. Drew University of Medicine and Science
Chizobam Ani, Charles R. Drew University of Medicine and Science
Islam Abudayyeh, Charles R. Drew University of Medicine and Science
Yunfan Zheng, University of California, Los Angeles
Cyril Rakovski, Chapman UniversityFollow
Ehsan Yaghmaei, Chapman UniversityFollow
Omolola Ogunyemi, Charles R. Drew University of Medicine and Science

Document Type

Article

Publication Date

2-25-2025

Abstract

The electrocardiogram (ECG) is a widely used, non-invasive tool for diagnosing a range of cardiovascular conditions, including arrhythmia and heart disease-related structural changes. Despite its critical role in clinical care, racial and ethnic differences in ECG readings are often underexplored or inadequately addressed in research. Variations in key ECG parameters, such as PR interval, QRS duration, QT interval, and T-wave morphology, have been noted across different racial groups. However, the limited research in this area has hindered the development of diagnostic criteria that account for these differences, potentially contributing to healthcare disparities, as ECG interpretation algorithms largely developed from major population data may lead to misdiagnoses or inappropriate treatments for minority groups. This review aims to help cardiac researchers and cardiovascular specialists better understand, explore, and address the impact of racial and ethnic differences in ECG readings. By identifying potential causes—ranging from genetic factors to environmental influences—and exploring the resulting disparities in healthcare outcomes, we propose strategies such as the development of race-specific ECG norms, the application of artificial intelligence (AI) to improve diagnostic accuracy, and the diversification of ECG databases. Through these efforts, the medical community can advance toward more personalized and equitable cardiovascular care.

Comments

This article was originally published in International Journal of Environmental Research and Public Health, volume 22, in 2025. https://doi.org/10.3390/ijerph22030337

Recommended Citation

Zheng, J.; Ani, C.; Abudayyeh, I.; Zheng, Y.; Rakovski, C.; Yaghmaei, E.; Ogunyemi, O. A Review of Racial Differences and Disparities in ECG. Int. J. Environ. Res. Public Health 2025, 22, 337. https://doi.org/10.3390/ijerph22030337

Peer Reviewed

1

Copyright

The authors

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.