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Right bundle branch block and risk of cardiovascular mortality: the Ibaraki Prefectural Health Study

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Abstract

Historically, a right bundle branch block has been considered a benign finding in asymptomatic individuals. However, this conclusion is based on a few old studies with small sample sizes. We examined the association between a complete right bundle branch block (CRBBB) and subsequent cardiovascular mortality in the general population in Japan. In this large community-based cohort study, data of 90,022 individuals (mean age, 58.5 ± 10.2 years; 66.2% women) who participated in annual community-based health check-ups were assessed. Subjects were followed up from 1993 to the end of 2016. Cox proportional hazards’ models and log-rank tests were used for the data analysis. CRBBB was documented in 1,344 participants (1.5%). Among all included participants, CRBBB was associated with an increased risk of cardiovascular mortality after adjustment for all potential confounders (hazard ratio [HR] 1.21; 95% confidence interval [CI] 1.06–1.38). The increased risk of cardiovascular mortality was particularly evident in women aged < 65 years (HR 2.00; 95% CI 1.34–2.98) and men aged ≥ 65 years (HR 1.28; 95% CI 1.06–1.55). CRBBB is associated with an increased risk of cardiovascular mortality in women aged < 65 years and men aged ≥ 65 years. Clinicians should be aware of the presence of CRBBB in young women and elderly men, even if they exhibit no symptoms.

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Acknowledgements

We thank the Ibaraki Health Service Association for supplying the health check-up data.

Funding

This work was supported by the Ibaraki Prefectural Government and by grants-in-aids from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan (Research on Health Services: H17-Kenkou-007; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H18-Junkankitou [Seishuu]-Ippan-012; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H20-Junkankitou [Seishuu]-Ippan-013; Intractable Diseases Conquest Research: H21-Nanchi-Ippan-059; and Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H23-Junkankitou [Seishuu]-Ippan-005, H26-Junkankitou [Seisaku]-Ippan-001 and H29-Junkankitou [Seishuu]-Ippan-003 and 20FA 1002).

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Authors and Affiliations

  1. Department of Clinical Laboratory Medicine, University of Tsukuba, Tsukuba, Japan

    Naomi Nakazawa & Yasushi Kawakami

  2. Department of Cardiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan

    Naomi Nakazawa, Tomoko Ishizu, Nobuyuki Murakoshi, Daishi Nakagawa, Tomofumi Nakatsukasa, Naoto Kawamatsu, Kimi Sato, Masayoshi Yamamoto, Tomoko Machino-Otsuka, DongZhu Xu, Akihiko Nogami, Kazutaka Aonuma & Masaki Ieda

  3. Ibaraki Health Plaza, Ibaraki Health Service Association, Mito, Japan

    Naomi Nakazawa, Tomoko Ishizu, Toshimi Sairenchi & Hitoshi Ota

  4. Center for Research Collaboration and Support, Comprehensive Research Facilities for Advanced Medical Science, Dokkyo Medical University, Mibu, Japan

    Toshimi Sairenchi

  5. Department of Public Health Medicine, University of Tsukuba, Tsukuba, Japan

    Kazumasa Yamagishi

  6. Department of Health and Welfare, Ibaraki Prefectural Office, Mito, Japan

    Fujiko Irie

  7. Ibaraki Health Service Association, Mito, Japan

    Takuji Tomizawa

  8. Department of Social and Environmental Medicine, Osaka University, Osaka, Japan

    Hiroyasu Iso

Authors
  1. Naomi Nakazawa
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  2. Tomoko Ishizu
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  3. Toshimi Sairenchi
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  4. Kazumasa Yamagishi
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  5. Nobuyuki Murakoshi
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  6. Daishi Nakagawa
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  7. Tomofumi Nakatsukasa
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  9. Kimi Sato
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  10. Masayoshi Yamamoto
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  11. Tomoko Machino-Otsuka
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  12. DongZhu Xu
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  13. Fujiko Irie
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  14. Takuji Tomizawa
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  15. Akihiko Nogami
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  16. Kazutaka Aonuma
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  17. Hiroyasu Iso
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  18. Masaki Ieda
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  19. Yasushi Kawakami
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  20. Hitoshi Ota
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Contributions

NN participated in the design of the study, analyzed the data, and wrote the first draft and the final report with all authors contributing to the editing. TI, TS, HO, and FI participated in the design of the study. TI, TS, HI, and KY gave important suggestions for the design of this study and interpretation of the results. FI arranged the acquisition of individual data. DN, TN, NK, KS, MY, TM-O, DZX, NM, TT, AN, KA, MI, and YK gave important suggestions for writing the draft and revising it critically for important intellectual content and read and approved the final manuscript.

Corresponding author

Correspondence to Tomoko Ishizu.

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Nakazawa, N., Ishizu, T., Sairenchi, T. et al. Right bundle branch block and risk of cardiovascular mortality: the Ibaraki Prefectural Health Study. Heart Vessels 37, 609–618 (2022). https://doi.org/10.1007/s00380-021-01944-6

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  • DOI: https://doi.org/10.1007/s00380-021-01944-6

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