title: Longitudinal tracking of left atrial diameter over the adult life course: Clinical correlates in the community.
abstract: BACKGROUND
  Increased left atrial diameter (LAD) is associated with elevated risk of atrial fibrillation (AF) and cardiovascular disease. Information is limited regarding the short- or long-term correlates of LAD.
  
  
  RESULTS
  We evaluated clinical correlates of LAD for a 16-year period in 4403 Framingham Study participants (mean age, 45 years; 52% women; median observations/participant=3) using multilevel modeling. We related age, sex, body mass index (BMI), systolic and diastolic blood pressure (BP), diabetes, and antihypertensive treatment to LAD. Sex-specific growth curves for LAD were estimated for individuals with low, intermediate, and high risk factor burden. We also related risk factors to changes in LAD during a 4-year period in 3365 participants. Age, male sex (3.83 mm compared to women), greater BMI, higher systolic BP (0.24 mm per 10 mm Hg increment), and antihypertensive treatment (0.54 mm) were associated positively with LAD (P<0.001). Men had a greater increase in LAD with BMI than women (2.02 versus 1.77 mm in women, per 5-unit increment), and individuals receiving antihypertensive treatment experienced a greater increase in LAD with age (0.95 versus 0.63 mm per 10-year age increment) when compared with those not receiving antihypertensive treatment. Overall, greater risk factor burden was positively associated with LAD. These risk factors were also associated positively with 4-year change in LAD (P<0.001).
  
  
  CONCLUSIONS
  Our longitudinal study of a large community-based sample identified higher BP and greater BMI as key modifiable correlates of LAD, suggesting that maintaining optimal levels of these risk factors through the life course may prevent atrial remodeling and AF.
authors.affiliation: Framingham Heart Study, MA 01702-5803, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: McManus
authors.forename: Vanessa
authors.initials: V
authors.lastname: Xanthakis
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Sullivan
authors.forename: Justin
authors.initials: J
authors.lastname: Zachariah
authors.forename: Jayashri
authors.initials: J
authors.lastname: Aragam
authors.forename: Martin G
authors.initials: MG
authors.lastname: Larson
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000473:pathology*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009929:Organ Size
chemical_list: D000959:Antihypertensive Agents