Blood Pressure Control and Incident Left-Ventricular Conduction Disease

PURPOSE OF REVIEW: 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 FINDINGS: 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.