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Funding Acknowledgements Vestre Viken Hospital Trust Background Left atrial (LA) enlargement is associated with elevated blood pressure (BP) and with cardiovascular morbidity and mortality. In the assessment of LA size, echocardiographic guidelines recommend the use of LA end-systolic volume (LAVmax). LA end-diastolic volume (LAVmin) and LA emptying fraction (LAEF) may add valuable information in risk assessment. The knowledge of early adulthood BP and its association to LA volumes and LAEF later in life is limited. Purpose To explore the association between systolic BP at age 40 and LA volumes and LAEF at age 64. Methods We linked data from subjects who had participated in both a nationwide cardiovascular screening survey (1990-1991) at the age of 40, and the Akershus Cardiac Examination (ACE) 1950 Study (2012-2015) at the age of 64 (n = 2,597). In the ACE 1950 Study, LAVmax and LAVmin were measured with echocardiography according to the summation of discs method. LAEF was calculated as (LAVmax-LAVmin/LAVmax)x100%. The association between systolic BP at age 40 and LA volumes and LAEF at age 64 was assessed in univariate and multivariate linear regression analyses. Results Systolic BP at age 40 was associated with LAVmax and LAVmin but not with LAEF at age 64. In our multivariate model, a 10 mm Hg higher systolic BP at age 40 was associated with a 0.9 ml greater LA end-systolic volume and a 0.5 ml greater LA end-diastolic volume at age 64. Conclusion Early adulthood systolic BP is associated with LA volumes 24 years later in life. Table. Association of systolic blood pressure at age 40 to left atrial (LA) volumes and LAEF at age 64 Univariate Multivariate* Dependent variable B (95% CI) p-value B (95% CI) p-value LAVmax (ml) 2.4 (2.0, 2.9) &amp;lt;0.001 0.9 (0.4, 1.4) 0.001 LAVmin (ml) 1.5 (1.1, 1.8) &amp;lt;0.001 0.5 (0.1, 0.9) 0.015 LAEF (%) -0.01 (-0.3, 0.3) 0.938 0.2 (-0.2, 0.5) 0.294 *Adjusted for gender, body mass index, smoking, resting heart rate and antihypertensive treatment, all assessed at age 40. B (95% CI), regression coefficient for systolic blood pressure (per 10 mm Hg) with 95% confidence interval; LAVmax, LA end-systolic volume; LAVmin LA end-diastolic volume; LAEF, LA emptying fraction

P1270 Systolic blood pressure at age 40 is associated with left atrial volumes at age 64