Association of Left Atrial Enlargement with Increased Left Ventricular Mass in Adult Nigerians with Long Standing Hypertension

Left atrial enlargement (LAE) is associated with increased risk of death and hospitalizations. We sought to determine the relationship between left atrial size and common demographic and echocardiographic parameters in adult Nigerians with long standing hypertension. A two dimensional echocardiography was performed on 81 patients with long standing hypertension and 80 normotensive controls after physical examination. The left ventricular mass (LVM) was calculated and indexed to body surface area to obtain the left ventricular mass index (LVMI). The hypertensive group was divided into those with left ventricular hypertrophy (LVH) and those without LVH based on their LVMI. Pearson’s Correlation Coefficient test was used to determine the relationship between LAE and demographic and echocardiographic parameters.The echocardiographic parameters were significantly higher in the hypertensive group than controls. Within hypertensives, they were significantly higher in those with LVH than those without LVH. The prevalence of LAE in the hypertensive population was 50.6%. It was more prevalent in those with LVH than those without LVH with rates of 80.5% versus 19.5% (χ2 = 9.586; p=0.002). The strongest correlate of LAE was LVM (r = 0.565; p<0.001) followed by LVH (r = 0.550; p<0.001). LAE is significantly associated with increased LVM and LVH in patients with long standing hypertension. This emphasizes the need for early institution and development of drugs that inhibit LVH in hypertensive patients.