TOPLINE:

High blood pressure (BP) at ages of 40-43 years was associated with an increased left atrial (LA) contractile strain at ages of 62-65 years in men, but not in women.

METHODOLOGY:

• Researchers assessed the long-term impact of BP at ages of 40-43 years on LA function at ages of 62-65 years.
• They included 2399 participants (51.6% women) whose BP was recorded at a mean age of 40.1 years, and LA function was measured at a mean age of 63.9 years.
• BP of patients was categorised on the basis of measurements in their early 40s as normal BP (< 120/< 70 mm Hg), elevated BP (120-139/70-89 mm Hg), or hypertension (≥ 140/≥ 90 mm Hg or use of antihypertensives).
• LA function was measured as LA reservoir and contractile strain using echocardiography.

TAKEAWAY:

• In men, higher BP in the early 40s was associated with an increased LA contractile strain in the early 60s (adjusted β, 1.03% per BP category increase; P = .002).
• In women, BP in the early 40s was not associated with later LA strain.
• Participants with higher BP in their early 40s had a higher LA stiffness index and higher left ventricular masses in their early 60s.

IN PRACTICE:

"The present study provides evidence of subtle sex differences in the LA functional response to increases in blood pressure two decades earlier in a large observational cohort with nearly equal participation between men and women," the researchers wrote.

"This may reflect blood pressure-related subtle cardiac remodelling with age, affecting men and women differently," they added.

SOURCE:

This study was led by Magnar Gangås Solberg, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway. It was published online on October 23, 2025, in Open Heart.

LIMITATIONS:

Selection bias may have existed as BP data were not available for all participants who underwent echocardiography. BP in the early 40s was measured only once, and BP data between the two examinations were missing.

DISCLOSURES:

This study received funding from the South-Eastern Norway Regional Health Authority. Additional support was received from the Vestre Viken Hospital Trust, Akershus University Hospital Trust, University of Oslo, and Norwegian Health Association. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.