title: Left atrial enlargement and risk of ischemic stroke in elderly treated hypertensive patients.
abstract: BACKGROUND
  The independent prognostic significance of left atrial enlargement is not yet completely clear. We investigated the association between left atrial enlargement and risk of ischemic stroke in elderly treated hypertensive patients.
  
  
  METHODS
  The occurrence of ischemic stroke was evaluated in 1,191 elderly treated hypertensive patients (age range = 60-90 years). Left atrium diameter (cm) was indexed by body surface area (m(2)) and subjects were divided into those with normal or enlarged (≥2.4cm/m(2)) left atrium.
  
  
  RESULTS
  During the follow-up (9.1±4.9 years; range = 0.4-20 years), 139 ischemic strokes occurred. The event rate per 100 patient-years was 1.28. There were 86 strokes in patients with normal (= 928) left atrium and 53 strokes in patients with enlarged (= 263) left atrium, respectively. Stroke-free survival curves were significantly different between the groups (P < 0.01). After adjustment for various covariables, including clinical variables, left ventricular hypertrophy, and ambulatory blood pressure parameters, Cox regression analysis showed that left atrial enlargement was significantly associated with increased risk of ischemic stroke (hazard ratio = 1.54; 95% confidence interval = 1.05-2.27; P = 0.03).
  
  
  CONCLUSIONS
  In elderly treated hypertensive patients, left atrial enlargement is an independent predictor of ischemic stroke.
authors.affiliation: Dipartimento 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.
authors.forename: Sante D
authors.initials: SD
authors.lastname: Pierdomenico
authors.affiliation: Centro di Ricerca Clinica, Fondazione Università Gabriele d'Annunzio, Chieti, Italy.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Pierdomenico
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università Gabriele d'Annunzio, Chieti, Italy;
authors.forename: Silvio
authors.initials: S
authors.lastname: Di Carlo
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università Gabriele d'Annunzio, Chieti, Italy;
authors.forename: Roberta
authors.initials: R
authors.lastname: Di Tommaso
authors.affiliation: Dipartimento di Medicina e Scienze dell'Invecchiamento, Università Gabriele d'Annunzio, Chieti, Italy; Centro di Ricerca Clinica, Fondazione Università Gabriele d'Annunzio, Chieti, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Cuccurullo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D001794:Blood Pressure / Q000187:drug effects*; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D006332:Cardiomegaly / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016009:Chi-Square Distribution; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; cardiovascular risk; hypertension; left atrium; stroke.