First-degree atrioventricular block is associated with advanced atrioventricular block, atrial fibrillation and left ventricular dysfunction in patients with hypertension

Jae Sun Uhm, Jaemin Shim, Jin Wi, Hee Sun Mun, Junbeom Park, Sung Ha Park, Boyoung Joung, Hui Nam Pak, Moon Hyoung Lee

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Abstract

OBJECTIVES: Clinical significance of first-degree atrioventricular block (AVB) have not been known in patients with hypertension. This study was performed to elucidate long-term prognosis of first-degree AVB in patients with hypertension. METHODS: We included 3816 patients (mean age, 61.0±10.6 years; men, 47.2%) with hypertension. We reviewed their ECGs and measured the PR interval. The patients were divided into two groups: normal PR interval (120ms≤PR≤200ms) and first-degree AVB (PR >200ms). We compared the incidence, cumulative incidence and hazard ratios of advanced AVB, sick sinus syndrome, atrial fibrillation and left ventricular dysfunction between the two groups during the follow-up period. RESULTS: The prevalence of first-degree AVB in patients with hypertension was 14.3%. The patients were followed up for 9.4±2.4 years. Incidence and cumulative incidence of advanced AVB, atrial fibrillation and left ventricular dysfunction in patients with first-degree AVB were significantly higher than in patients with normal PR interval. By multivariate Cox's regression, patients with first-degree AVB had an increased risk of advanced AVB [hazard ratio 2.77; 95% confidence interval (95% CI) 1.38-5.59; P=0.004], atrial fibrillation (hazard ratio 2.33; 95% CI 1.84-2.94; P<0.001) and left ventricular dysfunction (hazard ratio 1.49; 95% CI 1.11-2.00; P=0.009). However, sick sinus syndrome was not associated with first-degree AVB. CONCLUSION: First-degree AVB is an independent risk factor for future development of advanced AVB, atrial fibrillation and left ventricular dysfunction in patients with hypertension.

Original languageEnglish
Pages (from-to)1115-1120
Number of pages6
JournalJournal of hypertension
Volume32
Issue number5
DOIs
Publication statusPublished - 2014 May

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All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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