Prevalence of Pulmonary Hypertension in the General Population: The Rotterdam Study

Abstract

BackgroundPulmonary hypertension is characterized by increased pulmonary artery pressure and carries an increased mortality. Population-based studies into pulmonary hypertension are scarce and little is known about its prevalence in the general population. We aimed to describe the distribution of echocardiographically-assessed pulmonary artery systolic pressure (ePASP) in the general population, to estimate the prevalence of pulmonary hypertension, and to identify associated factors.MethodsParticipants (n = 3381, mean age 76.4 years, 59% women) from the Rotterdam Study, a population-based cohort, underwent echocardiography. Echocardiographic pulmonary hypertension was defined as ePASP>40 mmHg.ResultsMean ePASP was 26.3 mmHg (SD 7.0). Prevalence of echocardiographic pulmonary hypertension was 2.6% (95%CI: 2.0; 3.2). Prevalence was higher in older participants compared to younger ones (8.3% in those over 85 years versus 0.8% in those between 65 and 70), and in those with underlying disorders versus those without (5.9% in subjects with COPD versus 2.3%; 9.2% in those with left ventricular systolic dysfunction versus 2.3%; 23.1% in stages 3 or 4 left ventricular diastolic dysfunction versus 1.9% in normal or stage 1). Factors independently associated with higher ePASP were older age, higher BMI, left ventricular diastolic dysfunction, COPD and systemic hypertension.ConclusionIn this large population-based study, we show that pulmonary hypertension as measured by echocardiography has a low prevalence in the overall general population in the Netherlands, but estimates may be higher in specific subgroups, especially in those with underlying diseases. Increased pulmonary arterial pressure is likely to gain importance in the near future due to population aging and the accompanying prevalences of underlying disorders.

An Epidemiological Study of Pulmonary Hypertension by Echocardiography in Tertiary Care Institute, Tamilnadu, South India

“…The prevalence of pulmonary hypertension in our study is 1.59%, which is slightly lower than the study by Eduardo et al (20) Our study population comprises in patients, which is different from general population study. Geoff Strange et al (21) reported 9.1% pulmonary hypertension and 6.6 were reported in INCIPIT Study.…”

Serum-Free Thyroxine Levels Were Associated with Pulmonary Hypertension and Pulmonary Artery Systolic Pressure in Euthyroid Patients with Coronary Artery Disease

“…Another study in hemodialysis patients also found that PH was related to cigarette smoking [36]. In the Rotterdam Study [37], the mean age of their study subjects was 76.4 years which was similar to our population. The prevalence of PH was higher in older participants compared to that in younger ones, and older age was independently associated with higher PASP, which was in agreement with our findings.…”

Pulmonary function and diffusion capacity are associated with pulmonary arterial systolic pressure in the general population: The Rotterdam Study

“…A major limitation in this study is that we are not able to employ the gold standard for the diagnosis of pulmonary hypertension, which is right-heart catheterization. We were, however, quite conservative with respect to the definition of pulmonary hypertension based on echocardiography, which would more likely lead to an underestimation of the prevalence of pulmonary hypertension [10]. Also, ePASP has been shown to correlate will with invasively measured pulmonary arterial pressure, especially within the normal range of pulmonary arterial pressures, which most of the Rotterdam Study participants had [22e24].…”