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Effects of body mass index and blood pressure on atrioventricular block: Two-sample mendelian randomization

Xiying Chi1, Nan Zhang1, Long Zhang1

  • 1Department of Cardiology, Peking University First Hospital, Xicheng District, Beijing, China; Institute of Cardiovascular Disease, Peking University First Hospital, Xicheng District, Beijing, China.

Heart Rhythm
|November 2, 2023
PubMed

Insights

Elevated body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) causally increase the risk of atrioventricular (AV) block. Coronary artery disease (CAD) partially mediates these effects, highlighting a significant link between cardiometabolic factors and heart rhythm disturbances.

Area of Science:

  • Cardiology
  • Genetics
  • Epidemiology

Background:

  • Observational studies suggest links between atherogenic risk factors and atrioventricular (AV) block.
  • Understanding the causal relationship is crucial for developing effective prevention strategies.

Purpose of the Study:

  • To investigate the causal effects of cardiometabolic exposures on AV block using mendelian randomization.
  • To evaluate the mediating role of coronary artery disease (CAD) in the causal pathway.

Main Methods:

  • Two-sample bidirectional mendelian randomization was employed to assess causality between cardiometabolic traits and AV block.
  • Exposures included BMI, SBP, DBP, fasting glucose, fasting insulin, lipids, and triglycerides.
  • Multivariable mendelian randomization and mediation analysis were used to clarify direct and indirect effects.

Main Results:

  • Increased body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were causally associated with a higher risk of AV block.
  • No significant reverse causal effects were observed.
  • Coronary artery disease (CAD) mediated a substantial proportion of the risk from BMI, SBP, and DBP to AV block.

Conclusions:

  • Elevated BMI, SBP, and DBP are confirmed causal risk factors for AV block.
  • Coronary artery disease (CAD) plays a significant mediating role in the development of AV block influenced by these cardiometabolic factors.
Abstract

Keywords:
Atrioventricular blockBlood pressureBody mass indexCoronary artery diseaseMendelian randomization

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