Left atrial size in children with hypertension: the influence of obesity, blood pressure, and left ventricular mass.
OBJECTIVE
To evaluate the prevalence of left atrial enlargement and the correlates of left atrial size in children and adolescents with essential hypertension.


BACKGROUND
Left atrial enlargement has been associated with increased risk of cardiovascular disease, including stroke in adults. Risk factors for left atrial size in adults with hypertension include age, race, and obesity.


RESULTS
Patients (n =112; average age, 14.2 years) with essential hypertension were studied with echocardiography. The average left atrial dimension was 2.8 (+/- 0.5) cm; 51% patients had left atrial dimension >95% upper confidence limit. The patients with left atrial enlargement had greater body mass index (P <.05) than those without left atrial enlargement. In multiple regression analysis, height, body mass index, systolic blood pressure, and left ventricular geometry were significant independent correlates of left atrial size. Children with eccentric left ventricular hypertrophy were more likely to have a larger left atrial dimension.


CONCLUSIONS
Left atrial enlargement is prevalent in children and adolescents with essential hypertension. This may indicate an increased risk of cardiovascular disease morbidity and mortality. Control of obesity and blood pressure elevation offer two approaches for treatment that may prevent left atrial enlargement.
Daniels
Stephen R
SR
Division of Cardiology, Department of Pediatrics, University of Cincinnati, College of Medicine and the Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Witt
Sandra A
SA
Glascock
Betty
B
Khoury
Philip R
PR
Kimball
Thomas R
TR
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D007223:Infant; D007229:Infant Welfare; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D009820:Ohio / Q000453:epidemiology; D015995:Prevalence; D012044:Regression Analysis; D020257:Ventricular Remodeling / Q000502:physiology