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 hyper-tension. 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. Methods and 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.