TY - JOUR

T1 - Lifestyle habits associated with cardiac conduction disease

AU - Frimodt-Moller, Emilie K.

AU - Soliman, Elsayed Z.

AU - Kizer, Jorge R.

AU - Vittinghoff, Eric

AU - Psaty, Bruce M.

AU - Biering-Sorensen, Tor

AU - Gottdiener, John S.

AU - Marcus, Gregory M.

PY - 2023

Y1 - 2023

N2 - Aims Cardiac conduction disease can lead to syncope, heart failure, and death. The only available therapy is pacemaker implantation, with no established prevention strategies. Research to identify modifiable risk factors has been scant. Methods and results Data from the Cardiovascular Health Study, a population-based cohort study of adults >= 65 years with annual 12-lead electrocardiograms obtained over 10 years, were utilized to examine relationships between baseline characteristics, including lifestyle habits, and conduction disease. Of 5050 participants (mean age 73 +/- 6 years; 52% women), prevalent conduction disease included 257 with first-degree atrioventricular block, 99 with left anterior fascicular block, 9 with left posterior fascicular block, 193 with right bundle branch block (BBB), 76 with left BBB, and 102 with intraventricular block at baseline. After multivariable adjustment, older age, male sex, a larger body mass index, hypertension, and coronary heart disease were associated with a higher prevalence of conduction disease, whereas White race and more physical activity were associated with a lower prevalence. Over a median follow-up on 7 (interquartile range 1-9) years, 1036 developed incident conduction disease. Older age, male sex, a larger BMI, and diabetes were each associated with incident conduction disease. Of lifestyle habits, more physical activity (hazard ratio 0.91, 95% confidence interval 0.84-0.98, P = 0.017) was associated with a reduced risk, while smoking and alcohol did not exhibit a significant association. Conclusion While some difficult to control comorbidities were associated with conduction disease as expected, a readily modifiable lifestyle factor, physical activity, was associated with a lower risk.

AB - Aims Cardiac conduction disease can lead to syncope, heart failure, and death. The only available therapy is pacemaker implantation, with no established prevention strategies. Research to identify modifiable risk factors has been scant. Methods and results Data from the Cardiovascular Health Study, a population-based cohort study of adults >= 65 years with annual 12-lead electrocardiograms obtained over 10 years, were utilized to examine relationships between baseline characteristics, including lifestyle habits, and conduction disease. Of 5050 participants (mean age 73 +/- 6 years; 52% women), prevalent conduction disease included 257 with first-degree atrioventricular block, 99 with left anterior fascicular block, 9 with left posterior fascicular block, 193 with right bundle branch block (BBB), 76 with left BBB, and 102 with intraventricular block at baseline. After multivariable adjustment, older age, male sex, a larger body mass index, hypertension, and coronary heart disease were associated with a higher prevalence of conduction disease, whereas White race and more physical activity were associated with a lower prevalence. Over a median follow-up on 7 (interquartile range 1-9) years, 1036 developed incident conduction disease. Older age, male sex, a larger BMI, and diabetes were each associated with incident conduction disease. Of lifestyle habits, more physical activity (hazard ratio 0.91, 95% confidence interval 0.84-0.98, P = 0.017) was associated with a reduced risk, while smoking and alcohol did not exhibit a significant association. Conclusion While some difficult to control comorbidities were associated with conduction disease as expected, a readily modifiable lifestyle factor, physical activity, was associated with a lower risk.

KW - Conduction disease

KW - Atrioventricular block

KW - Bundle branch block

KW - Lifestyle habits

KW - Physical activity

KW - BUNDLE-BRANCH BLOCK

KW - PHYSICAL-ACTIVITY

KW - CARDIORESPIRATORY FITNESS

KW - MYOCARDIAL-ISCHEMIA

KW - RISK-FACTORS

KW - POPULATION

KW - MECHANISMS

KW - SMOKING

KW - COMPLICATIONS

KW - CONSUMPTION

U2 - 10.1093/eurheartj/ehac799

DO - 10.1093/eurheartj/ehac799

M3 - Journal article

C2 - 36660815

VL - 44

SP - 1058

EP - 1066

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

IS - 12

ER -