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

Jared W. Magnani, Faye L. Lopez, Elsayed Z. Soliman, Richard F. Maclehose, Richard S. Crow, Alvaro Alonso

Research output: Contribution to journalArticlepeer-review

44 Scopus citations


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).

Original languageEnglish (US)
Pages (from-to)666-672
Number of pages7
Issue number3
StatePublished - Mar 2012

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