Frimodt-Møller Emilie K, Marcus Gregory M
Steno Diabetes Center Copenhagen, Herlev, Denmark.
Division of Cardiology, Department of Medicine, University of California San Francisco, 505 Parnassus Ave, M1180B, San Francisco, CA, 94143, USA.
Curr Cardiol Rep. 2025 Jan 20;27(1):29. doi: 10.1007/s11886-025-02196-w.
Cardiac conduction disease, a harbinger of pacemaker implantation, heart failure, and death, is commonly regarded as immutable. However, emerging research suggests it may be a target for upstream prevention strategies such as blood pressure management. This review summarizes recent evidence regarding blood pressure control and the development of conduction disease.
Recent observational studies link hypertension to both prevalent and incident conduction disease. In randomized trials, intensive blood pressure control among hypertensive individuals reduced the incidence of left-ventricular conduction abnormalities in the form of fascicular- and left bundle branch blocks, while treatment with lisinopril independent of blood pressure control appeared to reduce conduction disease risk. Understanding factors that influence conduction system disease development may help inform novel primary prevention strategies. Recent evidence suggests that treatment of hypertension may play a key role in the prevention of conduction disease.
心脏传导疾病是起搏器植入、心力衰竭和死亡的先兆，通常被认为是不可改变的。然而，新出现的研究表明，它可能是血压管理等上游预防策略的目标。本综述总结了关于血压控制与传导疾病发展的最新证据。
近期的观察性研究将高血压与现患和新发的传导疾病联系起来。在随机试验中，高血压患者强化血压控制可降低束支和左束支传导阻滞形式的左心室传导异常的发生率，而赖诺普利治疗独立于血压控制似乎可降低传导疾病风险。了解影响传导系统疾病发展的因素可能有助于制定新的一级预防策略。最新证据表明，高血压治疗可能在预防传导疾病中起关键作用。
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