Obesity was a strong independent predictor of left atrial enlargement over 10 years (OR 2.4; P<0.001), with the highest incidence (31.6%) observed in obese hypertensive individuals.
Cohort (n=1,212)
No
Do obesity and hypertension increase the risk of left atrial enlargement over 10 years in the general population?
Obesity is a stronger independent predictor of left atrial enlargement than hypertension over a 10-year period in the general population.
Effect estimate: OR 2.4
p-value: p=<0.001
OBJECTIVES: This prospective study evaluated the association of obesity and hypertension with left atrial (LA) volume over 10 years. BACKGROUND: Although left atrial enlargement (LAE) is an independent risk factor for atrial fibrillation, stroke, and death, little information is available about determinants of LA size in the general population. METHODS: Participants (1,212 men and women, age 25 to 74 years) originated from a sex- and age-stratified random sample of German residents of the Augsburg area (MONICA S3). Left atrial volume was determined by standardized echocardiography at baseline and again after 10 years. Left atrial volume was indexed to body height (iLA). Left atrial enlargement was defined as iLA > or =35.7 and > or =33.7 ml/m in men and women, respectively. RESULTS: At baseline, the prevalence of LAE was 9.8%. Both obesity and hypertension were independent predictors of LAE, obesity (odds ratio OR: 2.4; p < 0.001) being numerically stronger than hypertension (OR: 2.2; p < 0.001). Adjusted mean values for iLA were significantly lower in normal-weight hypertensive patients (25.4 ml/m) than in obese normotensive individuals (27.3 ml/m; p = 0.016). The highest iLA was found in the obese hypertensive subgroup (30.0 ml/m; p < 0.001 vs. all other groups). This group also presented with the highest increase in iLA (+6.0 ml/m) and the highest incidence (31.6%) of LAE upon follow-up. CONCLUSIONS: In the general population, obesity appears to be the most important risk factor for LAE. Given the increasing prevalence of obesity, early interventions, especially in young obese individuals, are essential to prevent premature onset of cardiac remodeling at the atrial level.
Stritzke et al. (Sun,) conducted a cohort in Left atrial enlargement (n=1,212). Obesity and hypertension vs. Normal-weight normotensive individuals was evaluated on Left atrial enlargement (iLA ≥35.7 ml/m in men and ≥33.7 ml/m in women) (OR 2.4, p=<0.001). Obesity was a strong independent predictor of left atrial enlargement over 10 years (OR 2.4; P<0.001), with the highest incidence (31.6%) observed in obese hypertensive individuals.