Prevalence and risk factors of atrioventricular block among 15 million Chinese health examination participants in 2018: a nation-wide cross-sectional study

Abstract

Background Nationwide data on the prevalence of atrioventricular (AV) block are currently unavailable in China. Thus, we aimed to assess the prevalence and risk factors of AV block among Chinese health examination adults. Methods A total of 15,181,402 participants aged ≥ 18 years (mean age 41.5 ± 13.4 years, 53.2% men) who underwent an electrocardiogram as a part of routine health examination in 2018 were analyzed. AV block was diagnosed by physicians using 12-lead electrocardiogram. Overall and stratified prevalence (by age, sex, and city size) of all, first-, second- and third-degree AV block were calculated. Multivariable logistic regression analyses were performed to explore risk factors associated with AV block. Results AV block was observed in 88,842 participants, including 86,153 with first-degree, 2249 with second-degree and 440 with third-degree AV block. The age- and sex-standardized prevalence rate [95% confidence interval (CI)] of all, first-, second- and third-degree AV block were 7.06‰ (7.01–7.11), 6.84‰ (6.79–6.89), 0.18‰ (0.17–0.18) and 0.04‰ (0.03–0.04) respectively. After multivariable adjustment, the risk of AV block was positively associated with older age, being male, lower heart rate, higher body mass index, hypertension, diabetes and low high-density lipoprotein cholesterol. High total cholesterol was associated with a lower risk of AV block. Conclusion First-degree AV block is relatively common while severe AV block is rare in health examination adults. Besides, AV block was highly prevalent among the elderly. The risk of AV block was associated with older age, being male and metabolic factors.

Age and gender differences of electrocardiographic basic values and abnormalities in general adult population; Tehran Cohort Study

“…Another study, in a large population of more than 15 million people, estimated a prevalence rate of 6.84%, 0.18%, and 0.04% for first-, second-and third-degree AVB respectively. They also indicated that the AVB risk was associated with older age, male sex, lower HR, higher BMI, hypertension, DM and low HDL-C (55).…”

Sex differences in rates of permanent pacemaker implantation and in-hospital complications: A statewide cohort study of over 7 million persons from 2009–2018

“…Bradycardia or conduction blocks overall were higher in men (5.6% vs 1.9%). Shan et al described higher rates of CHB in men (0.05% vs 0.03%) in a study of 15 million people in China [ 24 ], as did Kojic et al in a prospective study of 18,912 residents of Reykjavik [ 25 ]. However there is no convincing evidence that age-dependent conduction disease requiring PPI in women is half that in men and therefore this cannot fully explain our findings.…”

Elimination of Vitamin D Signaling Causes Increased Mortality in a Model of Overactivation of the Insulin Receptor: Role of Lipid Metabolism

“…However, recent results point to a deleterious effect of low lipid levels on cardiovascular events, especially in atrial fibrillation (AF). Thus, a study on 15 million Chinese participants showed that low HDLC was independently associated with a higher risk of atrioventricular block, whereas high TC was a protective factor [ 38 ]. The protective effect of high levels of TC against AF has been demonstrated in many other studies in different populations in Korea, Japan, USA, China and Sweden [ 39 , 40 , 41 , 42 , 43 ].…”