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Ambulatory blood pressure, target organ damage and left atrial size in never-treated essential hypertensive

Cesare Cuspidi1, Stefano Meani, Cristiana Valerio

  • 1Istituto di Medicina Cardiovascolare and Centro Interuniversitario di Fisiologia, Clinica e Ipertensione, Università degli Studi di Milano and Ospedale Maggiore IRCCS, Milan, Italy. dhipertensione@libero.it

Journal of Hypertension
|July 9, 2005
PubMed

Insights

Left atrial enlargement is uncommon in newly diagnosed hypertension and unrelated to blood pressure. Factors like overweight and metabolic syndrome predict larger left atrial size.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Diagnostic Imaging

Background:

  • Essential hypertension is a global health concern.
  • Early detection of target organ damage is crucial for managing hypertension.
  • Left atrial size is a potential indicator of cardiovascular risk.

Purpose of the Study:

  • To examine the association between ambulatory blood pressure, target organ damage markers, and left atrial size in treatment-naive essential hypertensive patients.
  • To determine if left atrial enlargement is an early sign of hypertension.

Main Methods:

  • 519 patients with grade 1-2 essential hypertension underwent 24-hour ambulatory blood pressure monitoring, urine tests for microalbuminuria, echocardiography, and carotid ultrasonography.
  • Left atrial size was assessed via echocardiography.
  • Data on patient demographics, medical history, and lifestyle factors were collected.

Main Results:

  • Left atrial enlargement was found in 17.3% of patients.
  • No significant differences in blood pressure were observed between patients with and without enlarged left atria.
  • Older age, higher body mass index, smoking, metabolic syndrome, left ventricular hypertrophy, and carotid intima-media thickening were associated with increased left atrial size.

Conclusions:

  • Left atrial enlargement is not an early finding in young, never-treated hypertensive individuals.
  • Left atrial size is not directly related to ambulatory blood pressure in this population.
  • Overweight, left ventricular hypertrophy, carotid intima-media thickening, and metabolic syndrome are independent predictors of left atrial dimension, suggesting an adaptive response to combined cardiovascular and metabolic abnormalities.
Abstract

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