Pulmonary Arterial Hypertension in Hispanics

Abstract

Pulmonary hypertension (PH) is a medical condition characterized by elevated pressures in the pulmonary vessels. Pulmonary arterial hypertension (PAH), or pre-capillary PH, is a subgroup of the broader PH definition. PAH is rare compared to other groups of PH; its prevalence is about 15 cases per million in the adult population. Several disease processes may lead to PAH; however, the most common cause of PAH is idiopathic. Until recently, treatment for PAH was very limited and prognosis was dismal. Limitations in management remain present today but more treatment options are available for patients suffering from this condition. Most of the information available regarding PAH comes from registries in the United States and Europe. Limited information about epidemiology, treatment options, and response to the treatment is available for other ethnic groups such as Hispanics. In the world of medicine, we have learned from other more common medical conditions that components, such as genetics, environment, and culture may affect how diseases manifest and how they respond to treatment. It is important to be aware of how different ethnic groups exposed to different environmental conditions respond to different treatment modalities. The aim of this paper is to review the limited data available regarding PAH in Hispanics. This paper will review the information regarding the etiology, diagnosis, and treatment modalities available in South American and Central American countries. This paper will also review the data available for Hispanics diagnosed with PAH living in the United States. The goal is to highlight the difference in how PAH manifests in Hispanics compared to other ethnic groups. We aim to emphasize the importance of the lack of data available for this group and how it may be affecting the way we are treating Hispanics with PAH.

Pulmonary Hypertension in Hispanics: An Update on Treatment Options and Possible Causes

“…Additionally, even between different hispanic countries, there are differing etiologies of PAH. For instance, connective tissue disease is the underlying driver for PAH in Brazil but not frequently seen in Chile and Argentina (17). In the US, the NIH and the REVEAL (The Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management) registries do provide information about hispanic patients diagnosed with PAH, however both registries under-represent hispanic and asian patients(3).…”

“…In the US, the NIH and the REVEAL (The Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management) registries do provide information about hispanic patients diagnosed with PAH, however both registries under-represent hispanic and asian patients(3). In the Pulmonary Arterial Hypertension category in the US, hispanics represented 2.3% of the NIH registry at a time when it represented 6% of the US population (17). The underlying etiology for developing PAH has been proposed to differ by location in the world.…”