(Hypertension. 1995;25:1155-1160.)
© 1995 American Heart Association, Inc.
Articles |
Influence of Blood Pressure on Left Atrial Size
The Framingham Heart Study
From the Framingham (Mass) Heart Study, Framingham (S.M.V., M.G.L., E.J.B., D.L.); the Divisions of Cardiology and Clinical Epidemiology, Beth Israel Hospital, Boston, Mass (D.L.); the Division of Cardiology, Cleveland (Ohio) Clinic (M.S.L.); the Cardiology Section, Boston City Hospital (E.J.B.); Boston University School of Medicine (E.J.B., D.L.); the Division of Preventive Medicine and Epidemiology, Boston University School of Medicine (M.G.L.); and the National Heart, Lung, and Blood Institute, Bethesda, Md (D.L.).
Abstract Increased left atrial size has been identified as a
precursor of atrial fibrillation and of stroke once atrial fibrillation
is manifest. Conflicting data exist regarding the effect of high blood
pressure on left atrial size. Our objective was to evaluate the
association of contemporary and long-term measures of blood pressure
with echocardiographically determined left atrial size in a large,
population-based cohort. The study sample consisted of 1849 male and
2152 female participants of the Framingham Heart Study and Framingham
Offspring Study. All analyses were sex specific. In correlation
analyses, systolic and pulse pressures were identified as statistically
significant determinants of left atrial size after adjustment for age
and body mass index, although the magnitudes of these relations were
very modest (partial r
.10). Multivariable linear
regression models showed the relative contributions of the pressure
variables to the prediction of left atrial size to be substantially
less than those of age and, in particular, body mass index.
Furthermore, inclusion of left ventricular mass in these multivariable
models eliminated or attenuated the associations of the pressure
variables with left atrial size. In logistic analyses, increasing
levels of the pressure variables were significantly predictive of left
atrial enlargement. Subjects with 8-year average systolic pressure of
140 mm Hg or higher were twice as likely to have left atrial
enlargement as those with values of 110 mm Hg or lower. Overall, in
this population-based study sample, increased levels of systolic and
pulse pressures (but not diastolic or mean arterial pressures) were
significantly associated with increased left atrial size. However, the
magnitude of these associations was quite modest, particularly after
controlling for age and body mass index.
Key Words: atrial function, left • hypertension, essential • epidemiology • echocardiography
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