1. Loss of anterior forces (R waves) may signify prior anterior myocardial infarction. The aim of the present study was to determine the prevalence and prognostic impact of poor R-wave progression (PRWP) in a standard electrocardiogram (ECG) in a general population. Background The study comprised 5613 individuals (3151 women and 2462 men) aged 30 or older, who participated in the health examination including resting ECG. We defined PRWP as an R wave in the precordial lead V3 ≤3mm and R in lead V2≤ R in lead V3. Subjects with Q/QS in ECG and wide QRS were excluded using Minnesota codes 1.1-1.3 and Minnesota Code 7.7 respectively. Also, one individual with ECG signs of the Wolff-Parkinson- White syndrome was excluded. Logistic regression analysis was used to determine prevalences among groups. The t test was used for independent samples and the χ2 test for dichotomous variables, including mortality. The relative risks of PRWP for all-cause and cardiovascular death were estimated with a Cox proportional hazards model using the following covariates: age, hypertension, diabetes, previous MI and CHD. P<0.05 was considered statistically significant in all the analyses. Results In Cox regression analysis after adjustment for age, hypertension, diabetes, MI, CHD, the relative risk for all-cause mortality for PRWP was 1.69 (95% CI 0.89 – 3.22, p=0.112) for men and 2.00 (95% CI 1.28- 3.13, p<0.002) for women; risk of CV mortality for PRWP was 1.85 (95% 0.74-4.65, P=0.19) for men and 3.02 (1.54-5.93, P<0.001) for women. Conclusion PRWP is a common ECG finding and predicts risk for total and cardiovascular mortality in women in a general population. This finding could aid in screening general populations for risk of total and cardiovascular mortality. Relation of Poor R-wave Progression to Risk of Cardiovascular Mortality Anttila IJT 1, Nikus KC 2, Nieminen T 3 and Kähönen M 4 for The Health 2000 Survey (1) Department of Cardiology, Seinäjoki central Hospital, (2) Heart Center, Tampere University Hospital, (3) Department of Pharmacological Sciences, University of Tampere, (4) Department of Clinical Physiology, Tampere University Hospital, Finland References Anttila I, Nikus K, Nieminen T, Jula A, Reunanen A, Salomaa V, Kattainen A, Nieminen MS, Lehtimäki T, Virtanen V, Sclarovsky S and Kähönen M (2010): Prevalence and prognostic value of poor R-wave progression in standard resting electrocardiogram in a general adult population. The Health 2000 Survey. Annals of Medicine. 2010; 42: 135–142. Methods The prevalence of PRWP was 7.0% in women and 2.7% in men (p<0.001 for difference). Subjects with PRWP were older, had more diabetes, and coronary heart disease including MIs, than did those without PRWP. During follow-up of 5.8 ± 8 years (mean ±SD) 317 subjects died (5.6%). Both all-cause and CV mortality was higher in the group with PRWP than those without PRWP both in women and men. Declaration of interest Authors declare no conflict of interest regarding this poster presentation