Prevalence of pulmonary hypertension in COPD patients living at high altitude

Aguirre-Franco, Carlos; Torres-Duque, Carlos A.; Salazar, Gabriel; Casas, Alejandro; Jaramillo, Claudia; González-García, Mauricio

doi:10.1016/j.pulmoe.2021.12.006

Cited by 9 publications

(11 citation statements)

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“… 10 , 11 In a previous study in COPD patients residing in Bogotá, we demonstrated a high prevalence of PH, particularly in patients with less severe airflow obstruction. 12 Although there are several pathophysiological mechanisms related to the development of PH, probably the alveolar hypoxia at high altitude is a fundamental factor to promote and develop PH in these patients. 13 , 14 …”

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confidence: 99%

Effect of pulmonary hypertension on exercise capacity and gas exchange in patients with chronic obstructive pulmonary disease living at high altitude

et al. 2022

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Background: Pulmonary hypertension (PH) is associated with decreased exercise tolerance in chronic obstructive pulmonary disease (COPD) patients, but in the altitude the response to exercise in those patients is unknown. Our objective was to compare exercise capacity, gas exchange and ventilatory alterations between COPD patients with PH (COPD-PH) and without PH (COPD-nonPH) residents at high altitude (2640 m). Methods: One hundred thirty-two COPD-nonPH, 82 COPD-PH, and 47 controls were included. Dyspnea by Borg scale, oxygen consumption (VO2), work rate (WR), ventilatory equivalents (VE/VCO2), dead space to tidal volume ratio (VD/VT), alveolar-arterial oxygen tension gradient (AaPO2), and arterial-end-tidal carbon dioxide pressure gradient (Pa-ETCO2) were measurement during a cardiopulmonary exercise test. For comparison of variables between groups, Kruskal-Wallis or one-way ANOVA tests were used, and stepwise regression analysis to test the association between PH and exercise capacity. Results: All COPD patients had a lower exercise capacity and higher PaCO2, A-aPO2 and VD/VT than controls. The VO2 % predicted (61.3 ± 20.6 vs 75.3 ± 17.9; p < 0.001) and WR % predicted (65.3 ± 17.9 vs 75.3 ± 17.9; p < 0.001) were lower in COPD-PH than in COPD-nonPH. At peak exercise, dyspnea was higher in COPD-PH ( p = 0.011). During exercise, in COPD-PH, the PaO2 was lower ( p < 0.001), and AaPO2 ( p < 0.001), Pa-ETCO2 ( p = 0.033), VE/VCO2 ( p = 0.019), and VD/VT ( p = 0.007) were higher than in COPD-nonPH. In the multivariate analysis, PH was significantly associated with lower peak VO2 and WR ( p < 0.001). Conclusion: In COPD patients residing at high altitude, the presence of PH was an independent factor related to the exercise capacity. Also, in COPD-PH patients there were more dyspnea and alterations in gas exchange during the exercise than in those without PH.

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Section: Introductionmentioning

confidence: 99%

Effect of pulmonary hypertension on exercise capacity and gas exchange in patients with chronic obstructive pulmonary disease living at high altitude

et al. 2022

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“… 7 A meta-analysis also found that the prevalence of COPD was higher in high -altitude areas, especially in Asia, but the study concluded that altitude was not an independent risk factor, 8 which indicated that there were other risks factors involved in the occurrence of disease in high altitude areas. Some studies believe that high altitude hypoxic environment leads to more population having pulmonary hypertension, 9 which is related to the increase in the prevalence of COPD. There are also studies suggest that the prevalence of COPD is related to high PM2.5 exposure in high -altitude areas.…”

Section: Discussionmentioning

confidence: 99%

Investigation and Analysis of Risk Factors and Psychological Status of Chronic Obstructive Pulmonary Disease in Permanent Residents Aged 40 or Older in Hongyuan County, Aba Prefecture, Sichuan Province

Xia¹,

Zou²,

Yu³

et al. 2023

COPD

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Background COPD is an important public health problem worldwide, and there is a lack of epidemiological data on COPD in high-altitude areas in Sichuan province. Thus, we aimed to investigate the prevalence, risk factors and psychological status of COPD in Hongyuan County, Aba Prefecture, Sichuan Province, which is located at an average altitude of 3507 meters. Methods The 40 years old or greater permanent residents of Hongyuan County were selected by random sampling method, and the lung function test and questionnaires were conducted to determine the disease situation of COPD. The prevalence of COPD was compared among different factors of investigation, and multivariate logistic regression analysis was used for different factors to determine the independent influencing factors of COPD disease. Results A total of 456 permanent residents aged 40 years or older in Hongyuan County, 436 qualified for quality control, among which 53 cases confirmed COPD, the total prevalence was 12.16%, among which the prevalence was 14.55% for men and it was 8.07% for women. There were significant differences in different gender, ethnicity, age, smoking status, smoking years, educational level, heating style, history of tuberculosis, and prevalence of BMI (P <0.05). Binary logistic regression analysis showed that age ≥60 years (OR = 2.810, 95% CI: 1.0457.557), Han Nationality (OR: 3.238, 95% CI: 1.290–8.127), the heating method including biofuels (OR: 18.119, 95% CI: 4.140–79.303) and coals (OR: 6.973, 95% CI: 1.856–26.200), medical history of pulmonary tuberculosis (OR: 2.670, 95% CI: 1.278–5.578), the education level including junior high school (OR: 3.336, 95% CI: 1.2259.075), high school and above (OR: 5.910, 95% CI: 1.796–19.450), and smoking (OR: 10.774, 95% CI: 3.622–32.051) were independent risk factors for COPD disease. The prevalence of anxiety was 16.98%, and the prevalence of depression was 13.2%. Conclusion The prevalence of COPD in Hongyuan County was higher than the national level; age, ethnic group, education, smoking, heating method, and history of tuberculosis are the independent influencing factors of COPD in Hongyuan County. The prevalence of anxiety and depression is low.

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“…Previous studies showed that the rate of complicating PH in COPD patients and the PASP of COPD-PH patients at HA were higher than that at LA, which were similar to our results. (10,14,(23)(24)(25) These ndings suggested that PH could induced by HA,(26, 27) probably associated with chronic alveolar hypoxia which played a minor role in the development of PH in patients with COPD who resided at HA permanently. (11) Meanwhile, PH was more common in COPD patients with severe (GOLD 3) to very severe (GOLD 4) air ow restriction at HA, our result (HA: 73.53%, LA:47.22%) was similar to the previous studies, Aguirre-Franco C et al showed that the proportion of PH in COPD patients with severe to very severe air ow restriction at an average altitude of 2640m was 64.00%,(10) and Jatav V.S et al suggested that the proportion of PH in COPD patients with severe to very severe air ow restriction at an average altitude of 598m was 47.30%, (28)which suggested that a higher risk of complicating PH for COPD patients living at HA compared to COPD patients with similar air ow limitation living at LA.…”

Section: Multivariate Logistic Regression Analysis Indicated That The...mentioning

confidence: 99%

“…(8) Information about the differences of risk factors for PH in COPD patients between HA and LA was limited, Lei S et al just compared the characteristics of PH patients between LA and HA, and suggested that PH patients at HA had lower BNP and less severe PH than those living at LA. (9) Aguirre-Franco C et al (10) investigated the risk factors of PH in COPD patients at HA, which showed that GOLD 4 and hypoxemia were the independent risk factors of PH in COPD patients at HA, but patients from LA were not included.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and risk factors of chronic obstructive pulmonary disease complicated with pulmonary hypertension at different altitudes

Wang

Luo

2022

Preprint

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Background:Pulmonary hypertension (PH) is a common complication in patients with chronic obstructive pulmonary disease (COPD) and is closely related to poor prognosis. At present, researches about the risk factors of PH in COPD patients are limited, especially the human population at high altitude (HA). Objectives: To investigate the differences of clinical characteristics and related risk factors of patients with COPD/COPD-PH from low altitude (LA, 600m) and HA (2200m). Methods: We performed a cross-sectional survey of 228 COPD patients of Han nationality admitted to respiratory department of Qinghai People's Hospital (N=113) and West China Hospital of Sichuan University (N=115) From March 2019 to June 2021. PH was defined as a pulmonary arterial systolic pressure (PASP) >36 mmHg measured by transthoracic echocardiography (TTE). Results: In this study, the proportion of PH in COPD patients at HA was higher than that at LA (60.2% vs 31.3%). COPD-PH patients at HA showed significantly different in baseline characteristics, laboratory tests and pulmonary function test. Multivariate logistic regression analysis indicated that the independent related factors of PH in COPD patients are different between HA and LA. Conclusions: The proportion of COPD-PH at HA is higher than LA. At LA, increased BNP( B-type natriuretic peptide) and DB(direct bilirubin) were independent risk factors for PH in COPD patients. While at HA, higher BMI was independent protective factor and increased DB was independent risk factor for PH in COPD patients.

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Prevalence of pulmonary hypertension in COPD patients living at high altitude

Cited by 9 publications

References 58 publications

Effect of pulmonary hypertension on exercise capacity and gas exchange in patients with chronic obstructive pulmonary disease living at high altitude

Effect of pulmonary hypertension on exercise capacity and gas exchange in patients with chronic obstructive pulmonary disease living at high altitude

Investigation and Analysis of Risk Factors and Psychological Status of Chronic Obstructive Pulmonary Disease in Permanent Residents Aged 40 or Older in Hongyuan County, Aba Prefecture, Sichuan Province

Clinical characteristics and risk factors of chronic obstructive pulmonary disease complicated with pulmonary hypertension at different altitudes

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