Causes of Pulmonary Hypertension in the Elderly

Pugh, Meredith E.; Sivarajan, Lakshmi; Wang, Li; Robbins, Ivan M.; Newman, John H.; Hemnes, Anna R.

doi:10.1378/chest.13-1900

Cited by 54 publications

(45 citation statements)

References 21 publications

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“…In another study focusing on African Americans, despite the similarity in age (56.1±12.6 years) and female predominance (67.5%) of the studied population, PH was more associated with obesity, diabetes mellitus, and obstructive or restrictive spirometry patterns . In addition, Pugh and colleagues reported that WHO groups 2 and 3 were most frequently diagnosed (28% and 17%, respectively) in elderly patients (>65 years) with PH . Therefore, when looking at any registry, differences need to be identified between the target population, the intended population, and the population actually studied.…”

Section: Discussionmentioning

confidence: 98%

“…Choudhary and colleagues reported that the prevalence of PH in African Americans above 65 years of age was 10 times that of those younger than 45 years of age . The higher prevalence of PH in the elderly may be related to decreasing compliance of the pulmonary arteries with age . In addition, older male patients often have concomitant diseases, thereby resulting in worse outcomes .…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Factors in Patients With Pulmonary Hypertension—A Nationwide Cohort Study

Chang

Weng

Hsu

et al. 2016

JAHA

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BackgroundPulmonary hypertension (PH) is a rare but fatal condition. Large‐scale studies to examine the prognostic factors are lacking. In the present study, we aimed to investigate the factors associated with overall mortality in PH patients.Methods and ResultsBased on Taiwan's National Health Insurance Database, we identified 1092 newly identified PH patients between 1999 and 2011. These patients were matched with 8736 healthy subjects based on propensity score calculated with age, sex, and chronic cardiovascular risk factors. Overall mortality, death incidence rate ratio, and hazard ratio were calculated. Patients with PH had a higher mortality than controls (56.45 versus 18.51 per 1000 person‐years, P<0.0001), with hazard ratio at 3.3 (95% CI: 2.92–3.73, P<0.001). The long‐term survival rates of the PH patients at 1, 5, and 10 years were 87.9%, 72.5%, and 62.6%, respectively, which were significantly lower than controls with 98.4%, 90.8%, and 83.6% at 1, 5, and 10 years, respectively. Among patients with PH, the mortality rate was higher in the older and male patients. However, after stratifying by age and sex, the younger (<50 years) and female patients had a higher risk. Regarding different etiologies of PH, chronic obstructive pulmonary disease and pulmonary embolism led to most cases of mortality (adjusted hazard ratio: 3.2, 95% CI: 2.76–3.71 and 4.64, 95% CI: 2.74–7.87, P<0.05).Conclusions PH has high mortality, especially in females, and patients with younger age and with chronic diseases. Chronic obstructive pulmonary disease and pulmonary embolism contributed to an increased risk of mortality in PH patients.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Patients With Pulmonary Hypertension—A Nationwide Cohort Study

Chang

Weng

Hsu

et al. 2016

JAHA

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“…The age showed no statistical difference. In this study we tried to avoid old population for possible association with emphysematous lung changes [18,19]. Pulmonary hypertension can develop at any age according to underlining cause.…”

Section: Discussionmentioning

confidence: 99%

Study the Pulmonary Hypertension among Heavy Smokers Young Adult Males before the Clinical Evidences of Chronic Lung Disease

Naser¹,

Hadi²,

Ibrahim³

et al. 2017

J Clin Exp Cardiolog

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“…This finding deserves more attention. Studies have found that the most common type of PAH in the elderly is the type associated with left heart diseases, particularly left atrial or ventricular heart disease 4. Grigioni et al11 analyzed 196 cases of patients with class III–IV heart failure; after they adjusted for the clinical and laboratory examinations and other indicators, they found that PAH is an independent predictor of acute heart failure and cardiac death.…”

Section: Discussionmentioning

confidence: 99%

“…However, further research has found that the prevalence and mortality of PAH are on the rise in the elderly population 3,4. The pathogenesis of PAH is closely related to heart and pulmonary circulation.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary arterial hypertension in critically ill elderly patients

Zhang¹,

Xu²,

Chu³

et al. 2017

Pak J Med Sci

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Objective:To assess the incidence, possible risk factors and prognosis of pulmonary arterial hypertension (PAH) in critically ill elderly patients.Methods:We selected 122 cases admitted to the ICU, ages 60–93 years old. An echocardiography examination was performed within four days after admission to the ICU. PAH is usually suspected if the patient’s pulmonary artery systolic pressure ≥ 40 mmHg. We collected echocardiography data, relevant clinical data and routine laboratory data; we then used a statistical method to analyze the risk factors for PAH in critically ill elderly patients and examined its impact on the prognosis.Results:Total 51 patients were diagnosed with PAH. The prevalence of critically ill elderly patients with PAH was 41.8%. The ANOVA analysis showed that if patients had COPD (P = 0.031) and/or respiratory failure (P = 0.021), they were more prone to PAH. An enlarged left atrium (P = 0.038) and/or right ventricle (P = 0.029), a declining left ventricle fractional shortening rate (P = 0.038), and an elevated amount of the brain natriuretic peptides (P = 0.046) were all associated with the occurrence of PAH. Multivariate regression analysis showed that the left atrial diameter (P = 0.045) was the risk factor in critically ill elderly patients with PAH. The 30-day mortality rate was 33.3% for elderly patients with PAH, which is statistically significant (P = 0.035) when compared with the mortality rate of patients with normal pulmonary artery pressure. Our multivariate regression analysis also showed that, for critically ill elderly patients admitted in the ICU, PAH (P = 0.039) is risk factor for increased mortality.Conclusions:A higher incidence of PAH occurs in critically ill elderly patients. PAH is more likely to occur in patients with an enlarged left atrium, and these problems adversely impact the prognosis.

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Causes of Pulmonary Hypertension in the Elderly

Cited by 54 publications

References 21 publications

Prognostic Factors in Patients With Pulmonary Hypertension—A Nationwide Cohort Study

Prognostic Factors in Patients With Pulmonary Hypertension—A Nationwide Cohort Study

Study the Pulmonary Hypertension among Heavy Smokers Young Adult Males before the Clinical Evidences of Chronic Lung Disease

Pulmonary arterial hypertension in critically ill elderly patients

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