P wave indices, obesity, and the metabolic syndrome: the atherosclerosis risk in communities study

Obesity (Silver Spring). 2012 Mar;20(3):666-72. doi: 10.1038/oby.2011.53. Epub 2011 Apr 7.

Abstract

Atrial fibrillation and obesity are increasing in prevalence and are interrelated epidemics. There has been limited assessment of how obesity and the metabolic syndrome impact P wave indices, established electrocardiographic predictors of atrial fibrillation. We conducted a cross-sectional analysis to determine the association of obesity and the components of the metabolic syndrome with P wave indices in the population-based Atherosclerosis Risk in Communities (ARIC) study. Analyses were adjusted for demographic, anthropometric and clinical variables, and cardiovascular diseases and risk factors. Following relevant exclusions, 14,433 subjects were included (55% women and 24.7% black). In multivariable analyses, we identified significant, progressive increases in PR interval, P wave maximum duration, and P wave terminal force with BMI 25-30 kg/m(2) and BMI ≥30 kg/m(2) compared to the reference group <25 kg/m(2) (P < 0.0001 for trend for all P wave indices). These effects were present in both blacks and whites. Presence of metabolic syndrome was also associated with longer P wave indices. When components of the metabolic syndrome were examined separately, hypertension resulted in significant (P < 0.001) augmentation of the three P wave indices. Similarly, waist circumference was associated with greater P wave maximum duration in both races (P < 0.001). We concluded that P wave indices are significantly associated with obesity and particularly with hypertension and waist circumference. P wave indices may comprise intermediate markers, independent of age and cardiovascular risk, of the pathway linking obesity and with the risk of atrial fibrillation (AF).

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atherosclerosis / complications
  • Atherosclerosis / epidemiology*
  • Atherosclerosis / physiopathology
  • Atrial Fibrillation / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Electrocardiography
  • Female
  • Heart Conduction System / physiopathology*
  • Humans
  • Male
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / physiopathology
  • Middle Aged
  • Multivariate Analysis
  • Obesity / complications
  • Obesity / epidemiology*
  • Obesity / physiopathology
  • Risk Factors
  • Surveys and Questionnaires
  • United States / epidemiology