Incidence and prognosis of cardiac conduction system diseases in hypertension: the STEP trial.

Song Zhao, Yue Deng, Yixuan Wang, Shikai Yu, Jun Han, Jun Cai, Yi Zhang

Nature aging 2024 Apr

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Patients with cardiac conduction system diseases (CSD) may have increased incidence and mortality of cardiovascular events. Here we report a post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) randomized clinical trial (ClinicalTrials.gov number, NCT03015311) concerning the effect of intensive blood pressure (BP) control on the incidence of new-onset CSD and the prognostic implications of preexisting or new-onset CSD. The incidence of new-onset CSD was similar in the intensive (n = 205, 6.42%) and standard (n = 188, 5.94%) treatment arms. Participants with preexisting CSD had a higher risk for acute decompensated heart failure. Increased age, male sex and increased body mass index were independently associated with increased risk for new-onset CSD. Our results suggest that intensive BP control may not reduce the incidence of new-onset CSD compared with standard BP control. © 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.

Citation

Song Zhao, Yue Deng, Yixuan Wang, Shikai Yu, Jun Han, Jun Cai, Yi Zhang. Incidence and prognosis of cardiac conduction system diseases in hypertension: the STEP trial. Nature aging. 2024 Apr;4(4):483-490