Long-term impact of blood pressure in women and men in their early 40s on left atrial strain: data from the Akershus Cardiac Examination (ACE) 1950 Study.
The life-long exposure of the left heart chambers to systemic blood pressures may be important to changes in left atrial (LA) function with age, but long-term follow-up studies are scarce. We aimed to assess the impact of blood pressure in mid-life on LA function assessed by echocardiographic reservoir (LASr) and contractile (LASct) strain two decades later, in men and women.
Echocardiography was performed at ages 62-65 in 3706 participants born in 1950 of the prospective observational Akershus Cardiac Examination (ACE) 1950 Study. Data was linked with blood pressure measurements from the Age 40 Programme, a national health survey performed when the participants were 40-43 years of age. Participants were categorised into three groups representing normal blood pressure, elevated blood pressure and hypertension, based on measurements at ages 40-43. Linear regression models were used to assess associations between blood pressure and echocardiographic LA strain analysis.
A total of 2399 participants (51.6% women) had available LA strain analysis from the ACE 1950 Study (mean age 63.9±0.6 years) and blood pressure data from the Age 40 Programme (mean age 40.1±0.3 years). At ages 62-65, mean LASr was 35.1±9.2% and LASct was 17.7±5.6%. Adjusted regression models showed a significant association between blood pressure category increase at ages 40-43 and LASct (adjusted β 1.03% (95% CI 0.37% to 1.69%), p=0.002) at ages 62-65, but not with LASr. In women, no associations were evident between blood pressure at ages 40-43 and LA strain two decades later.
Increased blood pressure in the early 40s was associated with higher LA contractile strain two decades later in men, but not in women.
Echocardiography was performed at ages 62-65 in 3706 participants born in 1950 of the prospective observational Akershus Cardiac Examination (ACE) 1950 Study. Data was linked with blood pressure measurements from the Age 40 Programme, a national health survey performed when the participants were 40-43 years of age. Participants were categorised into three groups representing normal blood pressure, elevated blood pressure and hypertension, based on measurements at ages 40-43. Linear regression models were used to assess associations between blood pressure and echocardiographic LA strain analysis.
A total of 2399 participants (51.6% women) had available LA strain analysis from the ACE 1950 Study (mean age 63.9±0.6 years) and blood pressure data from the Age 40 Programme (mean age 40.1±0.3 years). At ages 62-65, mean LASr was 35.1±9.2% and LASct was 17.7±5.6%. Adjusted regression models showed a significant association between blood pressure category increase at ages 40-43 and LASct (adjusted β 1.03% (95% CI 0.37% to 1.69%), p=0.002) at ages 62-65, but not with LASr. In women, no associations were evident between blood pressure at ages 40-43 and LA strain two decades later.
Increased blood pressure in the early 40s was associated with higher LA contractile strain two decades later in men, but not in women.
Authors
Solberg Solberg, Berge Berge, Rønningen Rønningen, Enger Enger, Pervez Pervez, Bjørkan Orstad Bjørkan Orstad, Kvisvik Kvisvik, Aagaard Aagaard, Lyngbakken Lyngbakken, Ariansen Ariansen, Rosjo Rosjo, Steine Steine, Tveit Tveit
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