Elevated BP in early 40s linked to left atrial remodelling in later life

Systolic blood pressure (BP) levels in people in their early 40s are independently related to left atrial volumes in their mid‐60s, with greater BP being relevant for left atrial remodelling later in life, according to a study.

The study used data from individuals born in 1950 who participated in the Age 40 Program and the ACE (Akershus Cardiac Examination) 1950 Study. Researchers grouped the participants into quartiles of systolic BP in their early 40s and evaluated them in relation to the number of individuals with an enlarged left atrium in their mid‐60s.

A total of 2,591 individuals (50.3 percent women) were included in the analysis. At ages 40–43 years, mean systolic/diastolic BP was 128.1/78.3 mm Hg. About 20.7 percent of the participants had hypertension, and 1.3 percent were using antihypertensive medication. At ages 62–65 years, 60.7 percent of the participants had hypertension, and 34.7 percent were using BP-lowering treatment.

The average left atrial maximum volume indexed to body surface area (LAVi_max) was 26.5 mL/m², the average left atrial minimum volume indexed to body surface area was 14.6 mL/m², and the average left atrial emptying fraction (LAEF) was 45.5 percent. Thirty-two participants (1.2 percent) exhibited systolic dysfunction with left ventricular ejection fraction below 40 percent.

Of note, the number of participants with an enlarged left atrium increased across the quartiles of systolic BP (p=0.001). Linear regression analyses showed that systolic BP was independently associated with left atrial volumes, such that each 1-mm Hg increase in systolic BP at age 40–43 years correlated with 0.09-mL higher end‐systolic volume at age 62–65 years.