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Left atrial enlargement and risk of ischemic stroke in elderly treated hypertensive patients

Sante D Pierdomenico1, Anna M Pierdomenico2, Silvio Di Carlo3

  • 1Dipartimento di Medicina e Scienze dell'Invecchiamento, Università Gabriele d'Annunzio, Chieti, Italy; Centro di Ricerca Clinica, Fondazione Università Gabriele d'Annunzio, Chieti, Italy. santedonato.pierdomenico@fastwebnet.it.

American Journal of Hypertension
|April 1, 2014
PubMed

Insights

Left atrial enlargement independently predicts ischemic stroke risk in elderly hypertensive patients. This finding highlights the importance of monitoring atrial size for stroke prevention in this population.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • The prognostic value of left atrial enlargement in predicting ischemic stroke remains unclear.
  • Hypertension and aging are significant risk factors for stroke.

Purpose of the Study:

  • To investigate the association between left atrial enlargement and the risk of ischemic stroke.
  • To determine if left atrial enlargement is an independent predictor of ischemic stroke in elderly treated hypertensive patients.

Main Methods:

  • A cohort of 1,191 elderly treated hypertensive patients (60-90 years) was followed for a mean of 9.1 years.
  • Left atrial diameter was indexed to body surface area, with enlarged defined as ≥2.4 cm/m².
  • Cox regression analysis was used to assess the association between left atrial enlargement and ischemic stroke risk, adjusting for covariates.

Main Results:

  • 139 ischemic strokes occurred during follow-up.
  • Patients with enlarged left atria had a significantly higher incidence of ischemic stroke compared to those with normal left atria (P < 0.01).
  • Left atrial enlargement was independently associated with an increased risk of ischemic stroke (Hazard Ratio = 1.54; P = 0.03) after multivariable adjustment.

Conclusions:

  • Left atrial enlargement is an independent predictor of ischemic stroke in elderly treated hypertensive individuals.
  • Monitoring left atrial size may aid in risk stratification for ischemic stroke in this patient group.
Abstract

Keywords:
blood pressurecardiovascular riskhypertensionleft atriumstroke.

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