Incident Conduction System Disease Reduced by Lisinopril Therapy

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No significant difference in conduction outcome events with amlodipine
No significant difference in conduction outcome events with amlodipine

(HealthDay News) — Lisinopril therapy is associated with a significant reduction in incident conduction system disease, according to a study published online June 27 in JAMA Internal Medicine.

Thomas A. Dewland, M.D., from the Oregon Health and Science University in Portland, and colleagues examined the effect of pharmacologic therapy randomization and clinical risk factors on the incidence of conduction system disease in a secondary analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial investigation. A total of 21,004 ambulatory individuals aged 55 years or older with hypertension and at least one other cardiac risk factor were randomized to receive amlodipine besylate, lisinopril, or chlorthalidone. Participants underwent an electrocardiogram at study enrollment and every two years; they were followed for a mean of 5.0 years.

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The researchers found that randomization to lisinopril correlated with a significant reduction in conduction abnormalities compared with chlorthalidone (hazard ratio [HR], 0.81; 95 percent confidence interval [CI], 0.69 to 0.95). There was no significant difference in conduction outcome events for treatment with amlodipine (HR, 0.94; 95 percent CI, 0.81 to 1.09). There was no correlation for pravastatin treatment with reduced risk for incident disease compared with usual hyperlipidemia treatment (HR, 1.13; 95 percent CI, 0.95 to 1.35). Factors independently associated with increased risk for conduction system disease included increased age, male sex, white race, diabetes, and left ventricular hypertrophy.

"Further studies are warranted to determine whether pharmacologic treatment affects conduction abnormality outcomes, including pacemaker implantation," the authors write.

The study was partially funded by Pfizer; study medications were supplied by Pfizer, AstraZeneca, and Bristol-Myers Squibb.

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