Left atrial size in 164 hypertensive patients: An echocardiographic and ambulatory blood pressure study

Background: Left atrial enlargement (LAE) is associated with an increased r isk of death and cardiovascular (CV) hospitalization. Whether or not LAE re flects early structural change from hypertension is unclear. Hypothesis: The aim of this study was to evaluate the relationship between LA size, 24-h blood pressure measurements, age, body mass index (BMI), and left ventricular mass index (LVMI) in hypertensive patients. Methods: We studied 164 outpatients (age range 30-76 years, 73 men and 91 w omen) with mild to moderate hypertension. Physical examination, electrocard iogram, noninvasive blood pressure monitoring (ABPM), Doppler echocardiogra m were performed. Left ventricular mass index and LA dimensions were calcul ated. The sample was divided by age (< 60 and greater than or equal to 60 y ears), Results: Left ventricular hypertrophy (LVH) was present in 45% of patients aged < 60 years and in 70% of patients aged greater than or equal to 60 yea rs (p = 0.002). Left atrial enlargement (> 4 cm) was present in 35% of elde rly and in 24% of young patients (p = 0.31), and in 36% of patients with an d 21% of patients without LVH (p = 0.0057). There was no significant differ ence in the younger patients with and without LVH. The incidence of obesity was low (3 1 %) in the whole sample. The percentage of overweight in the e lderly patients with LVH and higher LA size was equally low. Multivariate a nalysis showed age (p = 0.044) and LVMI (p = 0.002) as the only significant predictors of LA enlargement. Conclusion: Since LAE is associated with a high risk of death and CV hospit alization, we emphasize the importance of development and use of drugs that inhibit LVH.