CARDIAC CONDUCTION DEFECTS AND CARDIOVASCULAR RISK FACTORS -A HOSPITAL BASED STUDY

Aadil Ashraf 1 , Touseef ahmad Mir 1 , Ahmad Wajeed Yousuf 1 , Gazzanfar Ali 2 , Javed Khan 1 and Irfan Gul 1 . 1. Senior Resident, Deptt. Of Medicine, Govt. Medical College, Srinagar. 2. Professor, Deptt. Of Medicine, Govt. Medical College, Srinagar. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History

A thorough general physical examination was done followed by a meticulous systemic examination with particular stress on Cardio respiratory system. Subjects were weighed without shoes on a weighing machine in kilograms and Height was measured in meters without shoes by making the subjects to stand against a wall on a firm level ground, wall being already marked with a measuring tape.BMI was calculated as per the following formula (Quetlets formulae) 5 : BMI = Weight in kgs / (Height ) 2

in meters.
Blood pressure was recorded in subjects in the right upper arm with a mercury sphygmomanometer in mmHg after making the patient to relax for five minutes. Complete Blood Count, Blood sugar, KFT/Na/K, Routine Urine examination, Chest XRAY, Lipid Profile, Liver function test, lipid profile and Serum Uric acid were routinely done in all patients.
A standard 12 lead ECG was taken with a paper speed of 25 mm/sec. In addition a one minute rhythm strip was also recorded.
The different cardiac conduction defects were diagnosed using the definitive criteria. 3,6,7,8 All the patients were screened for cardiovascular risk factors as per defined criteria: 1. Hypertension: was considered to be present if the patient was taking anti-hypertensive medication at the time of presentation or If blood pressure recorded was equal to or greater than 140 mm Hg systolic and, equal to or greater than 90 mm Hg Diastolic , at least on two separate occasions. 2. Diabetes Mellitus: was defined as patients diagnosed on the basis of fasting glucose 126 mg/dI or Serum HbA1c > 6.5% or symptoms of diabetes plus random blood glucose 200mg/d1 or patients on anti-diabetic drugs.. 3. Coronary Artery Disease(Cad) : was defined as patients with a history of stable angina, unstable angina, Myocardial infarction(New/old), angiographic evidence of Coronary Artery disease. 1202 4. Smoking: was defined as per CDC guidelines as any patient who had smoked at least 100 cigarettes in his/her entire life time and who at the time of survey smoked either everyday or some days.

Sedentary Life Style:
was defined after using the standard International Physical Activity Questionnaire(IPAQ), Revised November 2005. 9 6. Obesity: was defined as BMI of ≥ 25 kg / m 2 as per revised criteria for Asian Indians. 10,11 7. Dyslipidemia : was defined was if total Cholesterol was equal to or greater than 200 mg/dl ,LDL cholesterol equal to or greater than 130 mg/dl , HDL cholesterol less than 40 mg/dl and Serum Triglycerides 150 mg/dl or combination of these criteria 5. 8. Hyperuricemia: was defined as patients with an acute gout, serum uric acid more than 6.8mg/d1 in men and 6mg/dI in women or already on treatment tor hyperuricemia. 5 Statistical Methods: Statistical testing was conducted with the statistical package for the social science system version SPSS 20.0.Continuous variables are presented as mean ± SD and categorized into groups; Categorical variables are presented as frequencies and percentage. Nominal categorical data between the groups were compared using Chi-square test or Fisher's exact test as appropriate. p ˂0.05 was considered statistically significant.
Results:-  1710 Among males, most of the studied cases were in 70-79 years age group: 279(28.18%) and among females most of the studied cases were in the age group of 70-79 years: 179(24.86%). Mean age among males was (62 ± 16) years with minimum and maximum age of (22 and 94) years respectively. Mean age among females was (62 ± 15) years with minimum and maximum age of 23 and 95 years respectively. There was no statistical significance between age of males and females (p=0.88).Males were more as compared to females in all the age groups except 50-59 year age group (54.5 % females vs 45.5 % males). LBBB was the commonest conduction defect in both the sexes; 27.7% in males and 31.5% in females. In all the conduction defects, males were more as compared to females except in LPHB where females outnumbered males (57 % vs 43%).There was no statistical significance between males and females with regard to the conduction abnormalities(p=0.58). Of the studied cases, 1095 (64%) were hypertensive. Males were more 673 (68%) cases as compared to females 422(58.6%) and the difference was statistically significant ( p=0.04). The presence of hypertension in the studied population was found to be highly significant (p <0.0001).  . Females were more as compared to males with as statistical significance (p=0.030).The association of diabetes mellitus with cardiac conduction defects was found to be significant (p=0.029).        100.0% Of the studied cases, 496 (29%) were obese. Females were more 266 (36.9%) cases as compared to males 230(23.2%) and the difference was statistically significant ( p=0.001)The presence of obesity in the studied population was found to be significant (p =0.006).