Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Nat Aging. 2024 Apr;4(4):483-490. doi: 10.1038/s43587-024-00591-6. Epub 2024 Mar 21.
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.
患有心脏传导系统疾病（CSD）的患者心血管事件的发生率和死亡率可能会增加。在这里，我们报告了老年高血压患者血压干预策略（STEP）随机临床试验（ClinicalTrials.gov 编号：NCT03015311）的事后分析，该研究涉及强化血压（BP）控制对新发 CSD 发生率的影响，以及新发或原有 CSD 的预后意义。强化治疗组（n=205，6.42%）和标准治疗组（n=188，5.94%）新发 CSD 的发生率相似。患有原有 CSD 的患者发生急性失代偿性心力衰竭的风险更高。年龄较大、男性和体重指数增加与新发 CSD 的风险增加独立相关。我们的研究结果表明，与标准 BP 控制相比，强化 BP 控制可能不会降低新发 CSD 的发生率。
