Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period: The CARDIA study

Anderson C. Armstrong, Samuel S. Gidding, Laura A. Colangelo, Satoru Kishi, Kiang Liu, Stephen Sidney, Suma Konety, Cora E. Lewis, Luís C L Correia, Joao Lima

Research output: Contribution to journalArticle

Abstract

Objectives: We investigate how early adult and 20-year changes in modifiable cardiovascular risk factors (MRF) predict left atrial dimension (LAD) at age 43-55 years. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) study enrolled black and white adults (1985-1986). We included 2903 participants with echocardiography and MRF assessment in followup years 5 and 25. At years 5 and 25, LAD was assessed by M-mode echocardiography, then indexed to body surface area (BSA) or height. Blood pressure (BP), body mass index (BMI), heart rate (HR), smoking, alcohol use, diabetes and physical activity were defined as MRF. Associations of MRF with LAD were assessed using multivariable regression adjusted for age, ethnicity, gender and year-5 left atrial (LA) size. Results: The participants were 30±4 years; 55% white; 44% men. LAD and LAD/height were modest but significantly higher over the follow-up period, but LAD/BSA decreased slightly. Increased baseline and 20-year changes in BP were related to enlargement of LAD and indices. Higher baseline and changes in BMI were also related to higher LAD and LAD/height, but the opposite direction was found for LAD/BSA. Increase in baseline HR was related to lower LAD but not LAD indices, when only baseline covariates were included in the model. However, baseline and 20-year changes in HR were significantly associated to LA size. Conclusions: In a biracial cohort of young adults, the most robust predictors for LA enlargement over a 20-year follow-up period were higher BP and BMI. However, an inverse direction was found for the relationship between BMI and LAD/BSA. HR showed an inverse relation to LA size.

Original languageEnglish (US)
Article numbere004001
JournalBMJ Open
Volume4
Issue number1
DOIs
StatePublished - 2014

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Body Surface Area
Young Adult
Coronary Vessels
Body Mass Index
Heart Rate
Echocardiography
Blood Pressure
Smoking
Alcohols
Exercise
Hypertension
Direction compound

ASJC Scopus subject areas

  • Medicine(all)

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Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period : The CARDIA study. / Armstrong, Anderson C.; Gidding, Samuel S.; Colangelo, Laura A.; Kishi, Satoru; Liu, Kiang; Sidney, Stephen; Konety, Suma; Lewis, Cora E.; Correia, Luís C L; Lima, Joao.

In: BMJ Open, Vol. 4, No. 1, e004001, 2014.

Research output: Contribution to journalArticle

Armstrong, AC, Gidding, SS, Colangelo, LA, Kishi, S, Liu, K, Sidney, S, Konety, S, Lewis, CE, Correia, LCL & Lima, J 2014, 'Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period: The CARDIA study', BMJ Open, vol. 4, no. 1, e004001. https://doi.org/10.1136/bmjopen-2013-004001
Armstrong, Anderson C. ; Gidding, Samuel S. ; Colangelo, Laura A. ; Kishi, Satoru ; Liu, Kiang ; Sidney, Stephen ; Konety, Suma ; Lewis, Cora E. ; Correia, Luís C L ; Lima, Joao. / Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period : The CARDIA study. In: BMJ Open. 2014 ; Vol. 4, No. 1.
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abstract = "Objectives: We investigate how early adult and 20-year changes in modifiable cardiovascular risk factors (MRF) predict left atrial dimension (LAD) at age 43-55 years. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) study enrolled black and white adults (1985-1986). We included 2903 participants with echocardiography and MRF assessment in followup years 5 and 25. At years 5 and 25, LAD was assessed by M-mode echocardiography, then indexed to body surface area (BSA) or height. Blood pressure (BP), body mass index (BMI), heart rate (HR), smoking, alcohol use, diabetes and physical activity were defined as MRF. Associations of MRF with LAD were assessed using multivariable regression adjusted for age, ethnicity, gender and year-5 left atrial (LA) size. Results: The participants were 30±4 years; 55{\%} white; 44{\%} men. LAD and LAD/height were modest but significantly higher over the follow-up period, but LAD/BSA decreased slightly. Increased baseline and 20-year changes in BP were related to enlargement of LAD and indices. Higher baseline and changes in BMI were also related to higher LAD and LAD/height, but the opposite direction was found for LAD/BSA. Increase in baseline HR was related to lower LAD but not LAD indices, when only baseline covariates were included in the model. However, baseline and 20-year changes in HR were significantly associated to LA size. Conclusions: In a biracial cohort of young adults, the most robust predictors for LA enlargement over a 20-year follow-up period were higher BP and BMI. However, an inverse direction was found for the relationship between BMI and LAD/BSA. HR showed an inverse relation to LA size.",
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T1 - Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period

T2 - The CARDIA study

AU - Armstrong, Anderson C.

AU - Gidding, Samuel S.

AU - Colangelo, Laura A.

AU - Kishi, Satoru

AU - Liu, Kiang

AU - Sidney, Stephen

AU - Konety, Suma

AU - Lewis, Cora E.

AU - Correia, Luís C L

AU - Lima, Joao

PY - 2014

Y1 - 2014

N2 - Objectives: We investigate how early adult and 20-year changes in modifiable cardiovascular risk factors (MRF) predict left atrial dimension (LAD) at age 43-55 years. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) study enrolled black and white adults (1985-1986). We included 2903 participants with echocardiography and MRF assessment in followup years 5 and 25. At years 5 and 25, LAD was assessed by M-mode echocardiography, then indexed to body surface area (BSA) or height. Blood pressure (BP), body mass index (BMI), heart rate (HR), smoking, alcohol use, diabetes and physical activity were defined as MRF. Associations of MRF with LAD were assessed using multivariable regression adjusted for age, ethnicity, gender and year-5 left atrial (LA) size. Results: The participants were 30±4 years; 55% white; 44% men. LAD and LAD/height were modest but significantly higher over the follow-up period, but LAD/BSA decreased slightly. Increased baseline and 20-year changes in BP were related to enlargement of LAD and indices. Higher baseline and changes in BMI were also related to higher LAD and LAD/height, but the opposite direction was found for LAD/BSA. Increase in baseline HR was related to lower LAD but not LAD indices, when only baseline covariates were included in the model. However, baseline and 20-year changes in HR were significantly associated to LA size. Conclusions: In a biracial cohort of young adults, the most robust predictors for LA enlargement over a 20-year follow-up period were higher BP and BMI. However, an inverse direction was found for the relationship between BMI and LAD/BSA. HR showed an inverse relation to LA size.

AB - Objectives: We investigate how early adult and 20-year changes in modifiable cardiovascular risk factors (MRF) predict left atrial dimension (LAD) at age 43-55 years. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) study enrolled black and white adults (1985-1986). We included 2903 participants with echocardiography and MRF assessment in followup years 5 and 25. At years 5 and 25, LAD was assessed by M-mode echocardiography, then indexed to body surface area (BSA) or height. Blood pressure (BP), body mass index (BMI), heart rate (HR), smoking, alcohol use, diabetes and physical activity were defined as MRF. Associations of MRF with LAD were assessed using multivariable regression adjusted for age, ethnicity, gender and year-5 left atrial (LA) size. Results: The participants were 30±4 years; 55% white; 44% men. LAD and LAD/height were modest but significantly higher over the follow-up period, but LAD/BSA decreased slightly. Increased baseline and 20-year changes in BP were related to enlargement of LAD and indices. Higher baseline and changes in BMI were also related to higher LAD and LAD/height, but the opposite direction was found for LAD/BSA. Increase in baseline HR was related to lower LAD but not LAD indices, when only baseline covariates were included in the model. However, baseline and 20-year changes in HR were significantly associated to LA size. Conclusions: In a biracial cohort of young adults, the most robust predictors for LA enlargement over a 20-year follow-up period were higher BP and BMI. However, an inverse direction was found for the relationship between BMI and LAD/BSA. HR showed an inverse relation to LA size.

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