- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Aggressive BP lowering may prevent LV conduction disease: Sprint
Aggressive blood pressure (BP) control reduced the risk of left-ventricular conduction disease, finds a new clinical trial. The study is the first to provide causal evidence that cardiac conduction disease is preventable, according to researchers.
The findings of the study were presented as a late-breaking clinical trial at the Heart Rhythm Society's annual Heart Rhythm meeting (HRS 2022, 29 April–1 May, San Francisco, USA).
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. 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 Systolic Blood Pressure Intervention Trial (SPRINT) and randomized 3,918 hypertensive patients to standard BP treatment (target systolic BP < 140 mm Hg) and 3,956 participants to intensive BP treatment (target systolic BP < 120 mm Hg). The mean age was 67.6 ± 9.2 years and patients were observed for an average 3.5 years. Researchers used serial 12- lead electrocardiograms to track the development of left ventricular conduction disease and new ventricular pacing, examining the incidence of right bundle branch as a negative control.
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 (HR 0.74, 95% CI 0.56-0.98, P=0.038). Additionally, older age (HR 1.04, 95% CI 1.02-1.05, p=0.001), male sex (HR 2.31, 95% CI 1.63-3.32, p=0.001), and cardiovascular disease (HR 1.46, 95% CI 1.06-2.00, p=0.02) were associated with a heightened risk of developing LBBB or fascicular block. The statistically significant results persisted when incident ventricular pacing was included in the outcome. No relationship between randomization assignment and a negative control, right ventricular conduction disease, was observed (HR 0.95, 95% CI 0.71-1.27, p=0.75).
"Patient questions around how and why they were diagnosed with left ventricular conduction disease and the need to offer better answers inspired this study. We sought to uncover a prevention strategy for this common disorder," said senior author, Gregory Marcus, MD, MAS, University of California, San Francisco. "Before our trial, earlier studies were strictly observational. We hope these results will drive even more research dedicated to identifying modifiable characteristics of conduction disease and studying interventions that could help reduce patient risk."
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. They also call for additional studies to further understand how a reduction in conduction disease could impact the need for antihypertensive medications and other therapies.
Reference: Marcus GM. Effect of intensive versus standard blood pressure treatment on incident left ventricular conduction disease. Presented at: HRS 2022. April 29, 2022. San Francisco, CA.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751