Objective To understand the influencing factors of abnormal electrocardiogram(ECG)results among residents of Guangzhou from 2018 to 2022,and provide a scientific data for developing preventive measures.Methods A survey was conducted among residents in Guangzhou,and the ECGs of participants were scored.The data were statistically analyzed by using the Chi-square test and multivariate unordered multinomial logistic regression.Results A total of 2 070 subjects were included.The results showed that the protective factors for the people with ECG score of 1 to 2 were living in suburban areas,taking bus and subway,and the risk factors included working hours more than 4 hours(P<0.05).The protective factors for the people with ECG score of 3 to 4 were living in suburban areas and doing moderate to heavy outdoor exercise.Additionally,occasional exposure to secondhand smoke presented as a protective factor compared to regular exposure.The risk factors included the history of heart disease(P<0.05).Conclusion To promote cardiovascular health,it is advisable to avoid exposure to individuals who smoke,organize work hours in a reasonable manner,engage in appropriate physical exercise and choose public transport.