Suboptimal BP, Fasting Glucose Tied to Atrioventricular Block

Two modifiable variables potentially explain more than half of all atrioventricular blocks

TUESDAY, May 28, 2019 (Pharmacist's Briefing) -- Suboptimal blood pressure and fasting glucose levels are associated with atrioventricular (AV) block, according to a study published online May 24 in JAMA Network Open.

Tuomas Kerola, M.D., from Päijät-Häme Central Hospital in Lahti, Finland, and colleagues used data from the Mini-Finland Health Survey to examine demographics, comorbidities, habits, and laboratory and electrocardiographic (ECG) measurements as potential risk factors for incident AV block.

The researchers found that 8.6 percent of the 6,146 participants had ECG evidence of conduction disease and 0.9 percent experienced a hospitalization with AV block. Independent associations for AV block were seen for older age (hazard ratio for five-year increment, 1.34), male sex (hazard ratio, 2.04), a history of myocardial infarction (hazard ratio, 3.54), and a history of congestive heart failure (hazard ratio, 3.33). Independent associations were seen for two modifiable factors with AV block: Every 10-mm Hg increase in systolic blood pressure and every 20-mg/dL increase in fasting glucose level correlated with increased risk (hazard ratio, 1.22 for both). After adjustment for major coronary adverse events during follow-up, both remained statistically significant (hazard ratios, 1.26 and 1.22, respectively). If all participants exhibited ideal blood pressure and normal fasting glucose levels, an estimated 47 and 11 percent of AV blocks, respectively, may have been avoided.

"Effective treatment of hypertension and maintenance of normal blood glucose levels may be useful strategies in preventing AV block," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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