{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T13:17:15Z","timestamp":1767791835308,"version":"3.49.0"},"reference-count":25,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"unspecified","delay-in-days":115,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","award":["2018105"],"award-info":[{"award-number":["2018105"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,10,10]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The life-long exposure of the left heart chambers to systemic blood pressures may be important to changes in left atrial (LA) function with age, but long-term follow-up studies are scarce. We aimed to assess the impact of blood pressure in mid-life on LA function assessed by echocardiographic reservoir (LASr) and contractile (LASct) strain two decades later, in men and women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Echocardiography was performed at ages 62\u201365 in 3706 participants born in 1950 of the prospective observational Akershus Cardiac Examination (ACE) 1950 Study. Data was linked with blood pressure measurements from the Age 40 Programme, a national health survey performed when the participants were 40\u201343 years of age. Participants were categorised into three groups representing normal blood pressure, elevated blood pressure and hypertension, based on measurements at ages 40\u201343. Linear regression models were used to assess associations between blood pressure and echocardiographic LA strain analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2399 participants (51.6%\u2009women) had available LA strain analysis from the ACE 1950 Study (mean age 63.9\u00b10.6 years) and blood pressure data from the Age 40 Programme (mean age 40.1\u00b10.3 years). At ages 62\u201365, mean LASr was 35.1\u00b19.2% and LASct was 17.7\u00b15.6%. Adjusted regression models showed a significant association between blood pressure category increase at ages 40\u201343 and LASct (adjusted \u03b2 1.03% (95% CI 0.37% to 1.69%), p=0.002) at ages 62\u201365, but not with LASr. In women, no associations were evident between blood pressure at ages 40\u201343 and LA strain two decades later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increased blood pressure in the early 40s was associated with higher LA contractile strain two decades later in men, but not in women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003665","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:25:59Z","timestamp":1761290759000},"page":"e003665","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term impact of blood pressure in women and men in their early 40s on left atrial strain: data from the Akershus Cardiac Examination (ACE) 1950 Study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3880-3971","authenticated-orcid":false,"given":"Magnar Gang\u00e5s","family":"Solberg","sequence":"first","affiliation":[{"name":"Department of Medical Research, B\u00e6rum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trygve","family":"Berge","sequence":"additional","affiliation":[{"name":"Department of Medical Research, B\u00e6rum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Selmer","family":"R\u00f8nningen","sequence":"additional","affiliation":[{"name":"Department of Medical Research, B\u00e6rum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Enger","sequence":"additional","affiliation":[{"name":"Department of Medical Research, B\u00e6rum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Osman","family":"Pervez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"KG Jebsen Center for Cardiac Biomarkers, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eivind","family":"Bj\u00f8rkan Orstad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brede","family":"Kvisvik","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"KG Jebsen Center for Cardiac Biomarkers, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika Nerdrum","family":"Aagaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"KG Jebsen Center for Cardiac Biomarkers, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5994-9304","authenticated-orcid":false,"given":"Magnus Nakrem","family":"Lyngbakken","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"},{"name":"KG Jebsen Center for Cardiac Biomarkers, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8529-4826","authenticated-orcid":false,"given":"Inger","family":"Ariansen","sequence":"additional","affiliation":[{"name":"Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helge","family":"Rosjo","sequence":"additional","affiliation":[{"name":"KG Jebsen Center for Cardiac Biomarkers, Faculty of Medicine, University of Oslo, Oslo, Norway"},{"name":"Akershus Clinical Research Center (ACR), Division of Research and Innovation, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4265-3598","authenticated-orcid":false,"given":"Kjetil","family":"Steine","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"},{"name":"Department of Cardiology, Akershus University Hospital, L\u00f8renskog, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnljot","family":"Tveit","sequence":"additional","affiliation":[{"name":"Department of Medical Research, B\u00e6rum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2026010701111951000_12.2.e003665.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30752-2"},{"key":"2026010701111951000_12.2.e003665.2","first-page":"7","article-title":"2024 ESC Guidelines for the management of elevated blood pressure and hypertension: what is new in pharmacotherapy?","volume":"11","author":"McCarthy","year":"2025","journal-title":"Eur Heart J"},{"key":"2026010701111951000_12.2.e003665.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.2.724"},{"key":"2026010701111951000_12.2.e003665.4","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu018"},{"key":"2026010701111951000_12.2.e003665.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-004001","article-title":"Association of early adult modifiable cardiovascular risk factors with left atrial size over a 20-year follow-up period: the CARDIA study","volume":"4","author":"Armstrong","year":"2014","journal-title":"BMJ Open"},{"key":"2026010701111951000_12.2.e003665.6","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.121.023738","article-title":"Impact of Blood Pressure in the Early 40s on Left Atrial Volumes in the Mid-60s: Data From the ACE 1950 Study","volume":"11","author":"R\u00f8nningen","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2026010701111951000_12.2.e003665.7","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1093\/ehjci\/jeab191","article-title":"Imaging of the left atrium: pathophysiology insights and clinical utility","volume":"23","author":"Smiseth","year":"2021","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026010701111951000_12.2.e003665.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.07.027"},{"key":"2026010701111951000_12.2.e003665.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2011.04.014"},{"key":"2026010701111951000_12.2.e003665.10","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/ehjci\/jeaa415","article-title":"Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure","volume":"23","author":"Inoue","year":"2021","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026010701111951000_12.2.e003665.11","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey181"},{"key":"2026010701111951000_12.2.e003665.12","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/echo.14997","article-title":"Changes in left atrial phasic strain and mechanical dispersion: Effects of age and gender","volume":"38","author":"Stefani","year":"2021","journal-title":"Echocardiography"},{"key":"2026010701111951000_12.2.e003665.13","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/HJH.0000000000003615","article-title":"Left atrial mechanics evaluated by two-dimensional strain analysis: alterations in essential hypertension","volume":"42","author":"Stefani","year":"2024","journal-title":"J Hypertens"},{"key":"2026010701111951000_12.2.e003665.14","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/j.echo.2024.04.015","article-title":"Association of Cumulative Systolic Blood Pressure With Left Atrial Function in the Setting of Normal Left Atrial Size: The Atherosclerosis Risk in Communities (ARIC) Study","volume":"37","author":"Van\u2019t Hof","year":"2024","journal-title":"J Am Soc Echocardiogr"},{"key":"2026010701111951000_12.2.e003665.15","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g5992","article-title":"Sex differences in lifetime risk and first manifestation of cardiovascular disease: prospective population based cohort study","volume":"349","author":"Leening","year":"2014","journal-title":"BMJ"},{"key":"2026010701111951000_12.2.e003665.16","first-page":"308","article-title":"Heart and Brain Interactions--the Akershus Cardiac Examination (ACE) 1950 Study Design","volume":"49","author":"Berge","year":"2015","journal-title":"Scand Cardiovasc J"},{"key":"2026010701111951000_12.2.e003665.17","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn435"},{"key":"2026010701111951000_12.2.e003665.18","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"2026010701111951000_12.2.e003665.19","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jex244"},{"key":"2026010701111951000_12.2.e003665.20","first-page":"183","article-title":"Left ventricular mechanical dispersion in a general population: Data from the Akershus Cardiac Examination 1950 study","volume":"21","author":"Aagaard","year":"2020","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2026010701111951000_12.2.e003665.21","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey042"},{"key":"2026010701111951000_12.2.e003665.22","doi-asserted-by":"crossref","DOI":"10.1111\/echo.15852","article-title":"Left atrial function in middle-aged men and women with and without paroxysmal atrial fibrillation: Data from the Akershus Cardiac Examination (ACE) 1950 study","volume":"41","author":"Solberg","year":"2024","journal-title":"Echocardiography"},{"key":"2026010701111951000_12.2.e003665.23","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1016\/j.jacc.2022.02.013","article-title":"Sex-Based Differences in Heart Failure: JACC Focus Seminar 7\/7","volume":"79","author":"Khan","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026010701111951000_12.2.e003665.24","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.1007\/s00421-022-05018-x","article-title":"Sex as a main determinant of bi-atrial acute and chronic adaptation to exercise","volume":"122","author":"Simard","year":"2022","journal-title":"Eur J Appl Physiol"},{"key":"2026010701111951000_12.2.e003665.25","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac470"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2025-003665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T09:11:36Z","timestamp":1767777096000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2025-003665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,10,23]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/openhrt-2025-003665"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2025-003665","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}