| Left atrial size and risk of major cardiovascular events during antihypertensive treatment: losartan intervention for endpoint reduction in hypertension trial. | |
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MedLine Citation:
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PMID: 17178978 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The influence of left atrial size on cardiovascular events during antihypertensive treatment has not been reported previously from a long-term, prospective, randomized hypertension treatment trial. We recorded left atrial diameter by annual echocardiography and cardiovascular events in 881 hypertensive patients (41% women) with electrocardiographic left ventricular hypertrophy aged 55 to 80 (mean: 66) years during a mean of 4.8 years of randomized losartan- or atenolol-based treatment in the Losartan Intervention for Endpoint Reduction in Hypertension Study. During follow-up, a total of 88 primary end points (combined cardiovascular death, myocardial infarction, or stroke) occurred. In Cox regression, baseline left atrial diameter/height predicted incidence of cardiovascular events (hazard ratio: 1.98 per cm/m [95% CI: 1.02 to 3.83 per cm/m]; P=0.042) adjusted for significant effects of Framingham risk score and history of atrial fibrillation. Greater left atrial diameter reduction during follow-up was associated with greater reduction in left ventricular hypertrophy, absence of new-onset atrial fibrillation or mitral regurgitation during follow-up, and losartan-based treatment (B=-0.13+/-0.03 cm/m; P<0.001) in multiple linear regression, adjusting for baseline left atrial diameter/height. However, in time-varying Cox regression analysis, left atrial diameter reduction was not independent of left ventricular hypertrophy regression in predicting cardiovascular events during follow-up. In conclusion, left atrial diameter/height predicts risk of cardiovascular events independent of other clinical risk factors in hypertensive patients with left ventricular hypertrophy and may be useful in pretreatment clinical assessment of cardiovascular risk in these patients. |
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Authors:
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Eva Gerdts; Kristian Wachtell; Per Omvik; Jan Erik Otterstad; Lasse Oikarinen; Kurt Boman; Björn Dahlöf; Richard B Devereux |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2006-12-18 |
Journal Detail:
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Title: Hypertension Volume: 49 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-01-19 Completed Date: 2007-02-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 311-6 Citation Subset: IM |
Affiliation:
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Institute of Medicine, University of Bergen, Haukeland University Hospital, N-5021 Bergen, Norway. gerdtsev@online.no |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Antihypertensive Agents / therapeutic use* Atenolol / therapeutic use Cardiovascular Diseases / etiology*, mortality Echocardiography, Doppler* Female Follow-Up Studies Heart Atria* Humans Hypertension / complications*, drug therapy*, ultrasonography Hypertrophy, Left Ventricular / etiology, ultrasonography Incidence Losartan / therapeutic use* Male Middle Aged Predictive Value of Tests Risk Assessment Stroke / epidemiology, etiology |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 114798-26-4/Losartan; 29122-68-7/Atenolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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