JAMA Netw Open:控制血压和血糖可预防房室传导阻滞

2019-05-30 xujing 中国循环杂志

根据JAMA Netw Open发表的一项研究,控制血压和血糖可以有效预防房室传导阻滞。

根据JAMA Netw Open发表的一项研究,控制血压和血糖可以有效预防房室传导阻滞。
 
这项以人群为基础的队列研究纳入6146名社区居民。
 
研究发现,血压升高和血糖水平升高与房室传导阻滞的发生有关。
 
人口归因风险计算表明,血压和血糖水平升高可能与超过一半的房室传导阻滞有关。
 
529名(8.6%)有心脏传导疾病的心电图证据,58名(0.9%)因房室传导阻滞住院。
 
研究人员发现,老年(每增加5年的风险比[HR]为1.34)、男性(HR=2.04)、心肌梗死病史(HR=3.54)、心力衰竭病史(HR=3.33)均与房室传导阻滞有关。
 
两个可控的危险因素收缩压和血糖也与房室传导阻滞独立相关。收缩压每增加10mmHg,房室传导阻滞风险增加22%;空腹血糖每增加20 mg/dl,风险就增加19%。
 
即使在调整了其他主要不良冠状动脉事件后,房室传导阻滞仍与这些危险因素相关。
 
在人群归因风险评估中,研究者估计,如果所有参与者均达到理想血压,47%的房室传导阻滞可能被避免,如果所有参与者都有正常的空腹血糖水平,11%的房室传导阻滞可能被避免。
 
研究者指出,也许是因为起搏器如此成功和迅速地解决了心脏传导阻滞的问题,我们没有把注意力放在这种疾病的预防上,除可防治心肌梗死和心力衰竭外,有效治疗高血压和维持正常血糖可能也是有效的心脏传导阻滞预防策略。
 
原始出处: Kerola T, Eranti A, AroAL, et al. Risk factors associated with atrioventricular block. JAMA Netw Open. 2019, 2(5):e194176. 

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    2019-10-16 canlab
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    2019-08-14 feather89

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