Modifiable predictors of ventricular ectopy in the community

Tuomas Kerola, Thomas Dewland, Eric Vittinghoff, Susan R. Heckbert, Phyllis K. Stein, Gregory M. Marcus

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background—Premature ventricular contractions (PVCs) predict heart failure and death. Data regarding modifiable risk factors for PVCs are scarce. Methods and Results—We studied 1424 Cardiovascular Health Study participants randomly assigned to 24‐hour Holter monitoring. Demographics, comorbidities, habits, and echocardiographic measurements were examined as predictors of PVC frequency and, among 845 participants, change in PVC frequency 5 years later. Participants exhibited a median of 0.6 (interquartile range, 0.1–7.1) PVCs per hour. Of the more directly modifiable characteristics and after multivariable adjustment, every SD increase in systolic blood pressure was associated with 9% more PVCs (95% confidence interval [CI], 2%–17%; P=0.01), regularly performing no or low‐intensity exercise compared with more physical activity was associated with ≈15% more PVCs (95% CI, 3–25%; P=0.02), and those with a history of smoking exhibited an average of 18% more PVCs (95% CI, 3–36%; P=0.02) than did never smokers. After 5 years, PVC frequency increased from a median of 0.5 (IQR, 0.1–4.7) to 1.2 (IQR, 0.1–13.8) per hour (P<0.0001). Directly modifiable predictors of 5‐year increase in PVCs, described as the odds per each quintile increase in PVCs, included increased diastolic blood pressure (odds ratio per SD increase, 1.16; 95% CI, 1.02–1.31; P=0.02) and a history of smoking (OR, 1.31; 95% CI, 1.02–1.68; P=0.04). Conclusions—Enhancing physical activity, smoking cessation, and aggressive control of blood pressure may represent fruitful strategies to mitigate PVC frequency and PVC‐associated adverse outcomes.

Original languageEnglish (US)
Article numbere010078
JournalJournal of the American Heart Association
Volume7
Issue number22
DOIs
StatePublished - Nov 1 2018

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Polyvinyl Chloride
Confidence Intervals
Blood Pressure
Smoking
Social Adjustment
Ambulatory Electrocardiography
Smoking Cessation
Habits
Comorbidity
Heart Failure
Odds Ratio
Demography

Keywords

  • Population studies
  • Predictors
  • Premature ventricular beats

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kerola, T., Dewland, T., Vittinghoff, E., Heckbert, S. R., Stein, P. K., & Marcus, G. M. (2018). Modifiable predictors of ventricular ectopy in the community. Journal of the American Heart Association, 7(22), [e010078]. https://doi.org/10.1161/JAHA.118.010078

Modifiable predictors of ventricular ectopy in the community. / Kerola, Tuomas; Dewland, Thomas; Vittinghoff, Eric; Heckbert, Susan R.; Stein, Phyllis K.; Marcus, Gregory M.

In: Journal of the American Heart Association, Vol. 7, No. 22, e010078, 01.11.2018.

Research output: Contribution to journalArticle

Kerola, Tuomas ; Dewland, Thomas ; Vittinghoff, Eric ; Heckbert, Susan R. ; Stein, Phyllis K. ; Marcus, Gregory M. / Modifiable predictors of ventricular ectopy in the community. In: Journal of the American Heart Association. 2018 ; Vol. 7, No. 22.
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AB - Background—Premature ventricular contractions (PVCs) predict heart failure and death. Data regarding modifiable risk factors for PVCs are scarce. Methods and Results—We studied 1424 Cardiovascular Health Study participants randomly assigned to 24‐hour Holter monitoring. Demographics, comorbidities, habits, and echocardiographic measurements were examined as predictors of PVC frequency and, among 845 participants, change in PVC frequency 5 years later. Participants exhibited a median of 0.6 (interquartile range, 0.1–7.1) PVCs per hour. Of the more directly modifiable characteristics and after multivariable adjustment, every SD increase in systolic blood pressure was associated with 9% more PVCs (95% confidence interval [CI], 2%–17%; P=0.01), regularly performing no or low‐intensity exercise compared with more physical activity was associated with ≈15% more PVCs (95% CI, 3–25%; P=0.02), and those with a history of smoking exhibited an average of 18% more PVCs (95% CI, 3–36%; P=0.02) than did never smokers. After 5 years, PVC frequency increased from a median of 0.5 (IQR, 0.1–4.7) to 1.2 (IQR, 0.1–13.8) per hour (P<0.0001). Directly modifiable predictors of 5‐year increase in PVCs, described as the odds per each quintile increase in PVCs, included increased diastolic blood pressure (odds ratio per SD increase, 1.16; 95% CI, 1.02–1.31; P=0.02) and a history of smoking (OR, 1.31; 95% CI, 1.02–1.68; P=0.04). Conclusions—Enhancing physical activity, smoking cessation, and aggressive control of blood pressure may represent fruitful strategies to mitigate PVC frequency and PVC‐associated adverse outcomes.

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