Journal Club - Aggressive BP lowering to help preventing LV conduction disease

Conduction diseases are heart rhythm disorders that impact how electrical impulses travel through the heart. Left-ventricular conduction disease, which can appear as left bundle branch block (LBBB) or fascicular block, is a common disorder detected by routine EKG that can lead to heart failure, complete heart block and the need for a permanent pacemaker. Today, no strategies exist to help prevent the risk of left ventricular conduction disease.

The SPRINT trial that is the Systolic Blood Pressure Intervention Trial has found that aggressive blood pressure (BP) control reduced the risk of left-ventricular conduction disease. The study is the first to provide causal evidence that cardiac conduction disease is preventable.

The findings of the study were presented at the Heart Rhythm Society's annual Heart Rhythm meeting. This trial sought to determine whether aggressive BP control could potentially serve as a preventative strategy and reduce patient risk for incident left ventricular conduction disease. The study used the and randomized 3,918 hypertensive patients to standard BP treatment and 3,956 participants to intensive BP treatment.

Among all of the participants, 203 developed left-ventricular conduction disease. Random assignment to intensive BP control was associated with a 26% lower risk of left-ventricular conduction disease.

The authors of this trial believe that future efforts to mitigate the development and progression of conduction disease could change guidelines around diagnosis and treatment of the condition as well as the clinical perception of the disease.LBBB, BP, blood pressure, cardiac conduction, aggressive BP