Determinants of pulmonary hypertension in young adults

Guglin, Maya; Kolli, Swathy; Ren, Chao

doi:10.1111/ijcp.12008

Cited by 7 publications

(9 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The prevalence of PH of 6.8% in our community-based cohort is similar to the prevalence reported in large populations of mostly Caucasians evaluated by echocardiography for clinical reasons in the INCIPIT study in Italy (TR jet velocity 3m/s: prevalence of 6.6%) [27]. While one study had found AAs to have higher mean PA pressures independent of age, gender, BMI, smoking status, and presence of diastolic dysfunction [28], our findings do not support a higher prevalence of PH prevalence in AAs compared to the previous report based on the Italian cohort.…”

Section: Discussionsupporting

confidence: 83%

“…Although idiopathic pulmonary arterial hypertension is more prevalent in women, to the best of our knowledge this is the first study demonstrating the increased prevalence of PH overall in women in a population-based cohort. In contrast, a relationship between gender and PA pressures was not observed in a general population of young adults [28], in normal echocardiograms performed over a decade at Massachusetts General Hospital [29], or in the Olmstead County population cohort [1]. The gender influence on PH in our cohort was independent of age, BMI, and cardiovascular and pulmonary disease, which may suggest a role of race- and gender-specific biologic factors such as estrogen and estrogen metabolites [30–33] and needs further investigation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and Clinical Characteristics Associated with Pulmonary Hypertension in African-Americans

Choudhary

Jankowich

2013

PLoS ONE

View full text Add to dashboard Cite

BackgroundPulmonary hypertension (PH) is associated with increased mortality and morbidity. It is frequently associated with cardiopulmonary diseases that are prevalent in African Americans (AAs). However, the prevalence or determinants of PH in the AA population is not known. MethodsWe conducted a cross-sectional study to estimate the prevalence of PH (defined as trans-tricuspid gradient ≥ 35 mm Hg) and associated clinical characteristics in AAs using the Jackson Heart Study cohort (n=3,282) who underwent echocardiography and had a measurable trans-tricuspid regurgitant jet. Echocardiography is frequently used for screening for PH despite its limitations in estimating accurate PA systolic pressures. Overall and age-adjusted gender-specific prevalence were estimated and modified Poisson regression was used to identify independent clinical, spirometric, and echocardiographic characteristics associated with PH.ResultsThe mean age of the study population was 56.1 ± 12.6 years with 67.5% female. The prevalence of PH was 6.8%, with higher prevalence in female AAs (age-adjusted prevalence: Men 4.9%, 95% CI 3.6-6.2%; Women 7.7%, 95% CI 6.6-8.8%). Pulmonary hypertension prevalence increased with age (Prevalence Ratio: 10.0, 95%CI 4.0-25.1, >65 versus <45 years old), presence of obesity, higher pulse pressure, diabetes, obstructive or restrictive spirometry pattern, and severe left heart valvular disease. Also, PH was significantly associated with left atrial size and left ventricular ejection fraction.ConclusionsPulmonary hypertension is prevalent in AAs, more in women than in men. The identified cardiopulmonary risk factors that increase the prevalence of PH may assist in diagnosis and management of these at-risk subjects in the AA population.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Prevalence and Clinical Characteristics Associated with Pulmonary Hypertension in African-Americans

Choudhary

Jankowich

2013

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…When using the same PAAT cutoff of 110 ms as in previous studies (which corresponds to a pulmonary artery systolic pressure of 46 mm Hg), the prevalence of mild to moderate pulmonary hypertension was 11% in the obese group and 36% in the MetS group ( P =0.001). PAAT was modestly correlated with RV diastolic function in the MetS and obese groups ( r =0.22, P =0.007 for TV e′; r =0.25, P =0.002 for TV e′/a′ ratio).…”

Section: Resultsmentioning

confidence: 83%

“…Higher BMI has been associated with higher pulmonary pressures (estimated by tricuspid regurgitant jet velocity) in a large echocardiography‐based cohort . Pulmonary pressures, as estimated by PAAT, also correlated with BMI in the Coronary Artery Risk Development in Young Adults (CARDIA) study, in which the prevalence of mild–moderate pulmonary hypertension, as defined by a PAAT between 70.01 and 109.9 ms, was as high as 14% . Interestingly, metabolic disease has been associated with pulmonary arterial hypertension and pulmonary venous hypertension in small studies of patients with symptomatic disease.…”

Section: Discussionmentioning

confidence: 96%

“…23 Pulmonary pressures, as estimated by PAAT, also correlated with BMI in the Coronary Artery Risk Development in Young Adults (CARDIA) study, in which the prevalence of mild-moderate pulmonary hypertension, as defined by a PAAT between 70.01 and 109.9 ms, was as high as 14%. 20 Interestingly, metabolic disease has been associated with pulmonary arterial hypertension 24 and pulmonary venous hypertension 25 in small studies of patients with symptomatic disease. We have extended these findings to a preclinical cohort of young participants without known cardiovascular disease and demonstrated that, at similar levels of obesity, those with metabolic disease had significantly higher estimated pulmonary arterial systolic pressures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impaired Right Ventricular Hemodynamics Indicate Preclinical Pulmonary Hypertension in Patients With Metabolic Syndrome

Gopal

Santhanakrishnan

Wang

et al. 2015

JAHA

View full text Add to dashboard Cite

BackgroundMetabolic disease can lead to intrinsic pulmonary hypertension in experimental models. The contributions of metabolic syndrome (MetS) and obesity to pulmonary hypertension and right ventricular dysfunction in humans remain unclear. We investigated the association of MetS and obesity with right ventricular structure and function in patients without cardiovascular disease.Methods and ResultsA total of 156 patients with MetS (mean age 44 years, 71% women, mean body mass index 40 kg/m2), 45 similarly obese persons without MetS, and 45 nonobese controls underwent echocardiography, including pulsed wave Doppler measurement of pulmonary artery acceleration time (PAAT) and ejection time. Pulmonary artery systolic pressure was estimated from PAAT using validated equations. MetS was associated with lower tricuspid valve e′ (right ventricular diastolic function parameter), shorter PAAT, shorter ejection time, and larger pulmonary artery diameter compared with controls (P<0.05 for all). Estimated pulmonary artery systolic pressure based on PAAT was 42±12 mm Hg in participants with MetS compared with 32±9 and 32±10 mm Hg in obese and nonobese controls (P for ANOVA <0.0001). After adjustment for age, sex, hypertension, diabetes, body mass index, and triglycerides, MetS remained associated with a 20‐ms–shorter PAAT (β=−20.4, SE=6.5, P=0.002 versus obese). This association persisted after accounting for left ventricular structure and function and after exclusion of participants with obstructive sleep apnea.ConclusionsMetS is associated with abnormal right ventricular and pulmonary artery hemodynamics, as shown by shorter PAAT and subclinical right ventricular diastolic dysfunction. Estimated pulmonary artery systolic pressures are higher in MetS and preclinical metabolic heart disease and raise the possibility that pulmonary hypertension contributes to the pathophysiology of metabolic heart disease.

show abstract

Epidemiology of Pulmonary Hypertension: From Quaternary Referral Centre to the Community

Choudhary

Ventetuolo

2016

Pulmonary Hypertension

View full text Add to dashboard Cite

Determinants of pulmonary hypertension in young adults

Abstract: In this large, observational study of young adults, pulmonary hypertension, as assessed by echocardiography, is common. Diastolic dysfunction, obesity, physical inactivity and smoking are associated with elevated pulmonary arterial pressure in young adults.

Cited by 7 publications

References 23 publications

Prevalence and Clinical Characteristics Associated with Pulmonary Hypertension in African-Americans

Prevalence and Clinical Characteristics Associated with Pulmonary Hypertension in African-Americans

Impaired Right Ventricular Hemodynamics Indicate Preclinical Pulmonary Hypertension in Patients With Metabolic Syndrome

Epidemiology of Pulmonary Hypertension: From Quaternary Referral Centre to the Community

Contact Info

Product

Resources

About