Background:
Previous research has shown that socioeconomic status (SES) is a contributing factor toward a patient’s health. Lower SES has been associated with later presentation and worse outcomes in both chronic lung disease (CLD) patients and World Health Organization (WHO) group I pulmonary arterial hypertension patients. It is unknown if lower SES is associated with differing clinical characteristics at the time of diagnosis of group III pulmonary hypertension (secondary to CLD).
Methods:
Using WHO Group III pulmonary hypertension (PH) patients in our Michigan Medicine database (n=147), patients were divided into high (n=77) and low (n=70) SES groups by zip codes according to the 2012-2016 Michigan census data. Univariable analysis between cohorts was performed comparing demographic data, Pulmonary Arterial Pressure mean (PAPm), 6-minute walk (6MW), and Diffusion Capacity for Carbon Monoxide (DL
CO
) at the time of diagnosis.
Results:
Patients were similar in regard to gender (55.8% v. 65.7% female;
p=
0.221), average body mass index (33.35±9.42 v. 33.84±10.57;
p
=0.769), and average WHO functional class (2.87±0.56 v. 3.00±0.63;
p
=0.414). Lower SES patients presented at a significantly younger age than higher SES patients (63.79±13.35 v. 69.22±12.37;
p
=0.011). In regard to diagnostic testing, there were no significant differences between the low and high SES cohorts in average PAPm (42.31±10.76 v. 41.74±11.07;
p=0.827)
, 6MW (243.60±145.29 v. 296.00±179.83;
p
=0.310), and DL
CO
(13.00±12.71 v. 11.53±5.94;
p
=0.502).
Conclusion:
Lower SES patients were diagnosed with group III PH at a younger age than higher SES patients. It is reassuring that clinical characteristics associated with worse outcomes were similar. Further work is needed to understand reasons for the observed earlier age at the time of diagnosis.
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