Three modifiable risk factors – excessive alcohol consumption, high sedentary behavior and longer nighttime sleep duration – are associated with higher risk of cardiac conduction disease (CCD) in adults, suggesting a low-risk lifestyle may be beneficial for the primary prevention of CCD, according to results from the Kailuan study published May 20 in JACC: Asia.

Jiwen Zhong, MM, et al., identified 89,377 adult participants free of CCD at baseline who were part of the large-scale prospective Kailuan study in China. Data on modifiable lifestyle factors such as smoking, alcohol consumption, physical activity, sedentary behavior and nighttime sleep duration were collected to assess the relation between baseline and long-term lifestyle factors with incident CCD.

Results showed there were 3,723 cases of CCD over the median 14 years of follow-up, translating to 3.04 per 1,000 person-years (95% CI, 2.94-3.13 person-years). Compared with participants with a healthy lifestyle at baseline, those who did not were at higher risk of CCD, with adjusted hazard ratios of 1.16, 1.12 and 1.32, respectively, for consuming five or more alcoholic drinks per day, sedentary four or more hours per day and nighttime sleep for nine or more hours per day.

Looking at the long-term impact on CCD, compared with participants with a healthy baseline lifestyle, the adjusted HRs were 2.16, 1.77 and 1.67, respectively, for consuming five or more alcoholic drinks per day, sedentary four or more hours per day and nighttime sleep for nine or more hours per day.

Of note, in CCD cases, there was a higher prevalence of cardiovascular risk factors at baseline such as high BMI, hypertension and diabetes.

"Our findings highlight the importance of early management of lifestyle habits to mitigate the risk of CCD and alleviate the use of pacemaker implantation," write the authors. Along with public health strategies and relevant guidelines to address these risk factors, they suggest that health care providers should address the excess risks of these unhealthy lifestyles during check-ups. "Integrating these measures may reduce CCD risk and improve cardiovascular health," they add.