Association Between Modifiable Lifestyle Factors and Incident Cardiac Conduction Disease

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.

Keywords: cardiac alcohol consumption; conduction disease; lifestyle factors; nighttime sleep duration; sedentary behavior.

Graphical abstract

Figure 1

Associations of Baseline Lifestyle Habits With Incident Cardiac Conduction Disease We included baseline age, sex, educational level, monthly income, body mass index (BMI), the presence of hypertension, diabetes, myocardial infarction at baseline, and the baseline lifestyle factors (cigarette consumption, alcohol consumption, sedentary behavior, and nighttime sleep duration) in the Cox regression model. Circles denote HRs of the incident cardiac conduction disease, and error bars denote 95% CIs.

Figure 2

Cumulative Incidence of Cardiac Conduction Disease by Lifestyle Habits The figure shows the adjusted Kaplan-Meier cumulative incidence curves (adjusted for age and sex) for cardiac conduction disease according to level of alcohol consumption (A), sedentary behavior (B), and nighttime sleep duration (C). The shaded areas in different colors represent the 95% CIs for the cumulative incidence.

Figure 3

Associations of Long-Term Lifestyle Habits With Incident Cardiac Conduction Disease In the analysis of the association between long-term lifestyle habits and cardiac conduction disease, sex and educational level were considered time-invariant variables, while other covariates including age, monthly income, body mass index (BMI), hypertension, diabetes, myocardial infarction, and lifestyle habits (alcohol consumption, sedentary behavior, and nighttime sleep duration) were treated as time-variant variables. Circles denote HRs for incident cardiac conduction disease, and error bars denote 95% CIs.

Central Illustration

Lifestyle Factors and Incident Cardiac Conduction Disease Individuals with excessive alcohol consumption, high sedentary behavior, and longer nighttime sleep duration were related with higher risks of incident cardiac conduction disease, especially for the individuals with long-term adherence to the unhealthy lifestyles. CCD = cardiac conduction disease.