Association Between Modifiable Lifestyle Factors and Incident Cardiac Conduction Disease

Q: What are the key findings of this study?

Excessive alcohol consumption (≥5 drinks/day), high sedentary behavior (≥4 hours/day), and longer sleep duration (≥9 hours/day) were associated with higher risks of incident cardiac conduction disease, with HRs of 1.16, 1.12, and 1.32 respectively.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Incident Cardiac Conduction Disease (n=89377). Intervention: Excessive alcohol consumption vs. 0 drinks/day (healthy lifestyle). Primary outcome: Incident Cardiac Conduction Disease (HR 1.16, 95% CI 1.04-1.32).

Q: What does this research mean for the field?

Excessive alcohol consumption (≥5 drinks/day), high sedentary behavior (≥4 hours/day), and longer sleep duration (≥9 hours/day) are associated with higher risks of incident cardiac conduction disease. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Jiwen Zhong; Rui Tang; Liuxin Li; Wei Zheng; Shuohua Chen; Jun Feng; Jie Qu; Xi Wang; Yudong Yin; Yuan Yu; Shouling Wu

doi:10.1016/j.jacasi.2025.03.009

May 20, 2025JACC AsiaOpen Access

Association Between Modifiable Lifestyle Factors and Incident Cardiac Conduction Disease

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Key result

Excessive alcohol, sedentary behavior, and long sleep linked to up to ~32% higher conduction disease risk.

Figures

Graphical abstract published by JACC Asia — Graphical abstract · Published by JACC Asia · CC BY-NC-ND

Why the study?

The associations between modifiable lifestyles and cardiac conduction disease were poorly studied.

Do unhealthy lifestyle factors (excessive alcohol, sedentary behavior, long sleep) increase the risk of incident cardiac conduction disease in adults?

Key Points

To prospectively investigate the individual associations of baseline and sustained modifiable lifestyle factors with incident cardiac conduction disease.
Prospective cohort study of 89,377 participants aged 18–90 years without baseline cardiac conduction disease from the Kailuan cohort.
Evaluated smoking, alcohol consumption, physical activity, sedentary behavior, and nighttime sleep duration over a median follow-up of 14.1 years (1,226,634.1 person-years).
A total of 3,723 incident cardiac conduction disease cases occurred during follow-up (incidence rate: 3.04 per 1,000 person-years; 95% CI: 2.94–3.13).
Baseline alcohol intake ≥5 drinks/day (HR: 1.16; 95% CI: 1.04–1.32), sedentary time ≥4 hours/day (HR: 1.12; 95% CI: 1.03–1.22), and sleep ≥9 hours/night (HR: 1.32; 95% CI: 1.02–1.68) significantly elevated disease risk.
Chronic adherence to poor lifestyle factors showed higher risks: alcohol ≥5 drinks/day (adjusted HR: 2.16; 95% CI: 1.68–2.79), sedentary behavior ≥4 hours/day (adjusted HR: 1.77; 95% CI: 1.50–2.09), and sleep ≥9 hours/night (adjusted HR: 1.67; 95% CI: 1.25–2.24).

Study Design

Type

Cohort (n=89,377)

Structured PICO

Do unhealthy lifestyle factors (excessive alcohol, sedentary behavior, long sleep) increase the risk of incident cardiac conduction disease in adults?

P

Population

89,377 adults (aged 18-90 years) free of cardiac conduction disease at baseline from the Kailuan cohort, mean age 50.8, 78.5% male.

I

Intervention

Unhealthy lifestyle factors (alcohol consumption ≥5 drinks per day, sedentary behavior ≥4 hours per day, and night sleep ≥9 hours per day)

C

Comparator

Healthy lifestyle factors at baseline and long-term (no alcohol consumption, sedentary behavior <4 hours per day, and night sleep 7-9 hours)

O

Outcome

Incident cardiac conduction disease (including atrioventricular block, left bundle branch block, and right bundle branch block)composite

Main Result

Effect estimate: HR 1.16 (95% CI 1.04-1.32)

Excessive alcohol consumption, high sedentary behavior, and longer sleep duration are independently associated with a higher risk of incident cardiac conduction disease.

Limitations

Observational study design prevents establishing a causal relationship.
Lifestyle data were self-reported, potentially leading to recall bias.
Potential residual confounding from unmeasured factors.
Absence of thyroid-related data, which is a contributor to cardiac conduction disease.
Lack of detailed information on physical activity, including its type, intensity, and duration.

Implication

These associations should not yet change practice; hypothesis-generating for lifestyle trials in conduction disease prevention.

Abstract

BACKGROUND: The associations between modifiable lifestyles and cardiac conduction disease (CCD) are poorly studied. OBJECTIVES: This study aimed to prospectively assess the association between modifiable lifestyle factors and incident CCD. METHODS: A total of 89,377 participants (aged 18-90 years) free of CCD at baseline were enrolled in the Kailuan cohort. Lifestyle factors, including smoking, alcohol consumption, physical activity, sedentary behavior, and nighttime sleep duration, were collected to test the relations of both baseline and long-term lifestyle factors with incident CCD. RESULTS: During 1,226,634.1 person-years of follow-up (median: 14.1 years; Q1-Q3: 13.8-14.2 years), 3,723 CCD cases (3.04 per 1,000 person-years; 95% CI: 2.94-3.13 person-years) were identified. Compared with the participants who had healthy lifestyles at baseline, the adjusted HRs for participants who consumed alcohol ≥5 drinks per day, had sedentary behavior ≥4 hours per day, and had night sleep ≥9 hours per day were 1.16 (95% CI: 1.04-1.32), 1.12 (95% CI: 1.03-1.22), and 1.32 (95% CI: 1.02-1.68), respectively. Furthermore, compared with the participants adhered to long-term healthy lifestyles, the adjusted HRs for participants who chronically consumed alcohol ≥5 drinks per day, had sedentary behavior ≥4 hours per day, and had night sleep ≥9 hours per day were 2.16 (95% CI: 1.68-2.79), 1.77 (95% CI: 1.50-2.09), and 1.67 (95% CI: 1.25-2.24), respectively. CONCLUSIONS: The study revealed excessive alcohol consumption, high sedentary behavior, and longer sleep duration were associated with higher risks of CCD in adults. The findings supported the beneficial impact of a low-risk lifestyle on the primary prevention of CCD.

Discussion

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Cite This Study

Zhong et al. (2025) conducted a cohort in Incident Cardiac Conduction Disease (n=89,377). Excessive alcohol consumption vs. 0 drinks/day (healthy lifestyle) was evaluated on Incident Cardiac Conduction Disease (HR 1.16, 95% CI 1.04-1.32). Excessive alcohol consumption (≥5 drinks/day), high sedentary behavior (≥4 hours/day), and longer sleep duration (≥9 hours/day) were associated with higher risks of incident cardiac conduction disease, with HRs of 1.16, 1.12, and 1.32 respectively.

synapsesocial.com/papers/6a1547dab2e0231f158237d0 https://doi.org/10.1016/j.jacasi.2025.03.009

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Association Between Modifiable Lifestyle Factors and Incident Cardiac Conduction Disease

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association Between Modifiable Lifestyle Factors and Incident Cardiac Conduction Disease

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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