The Impact of Socioeconomic, Racial, and Ethnic Disparities on Pulmonary Hypertension Diagnosis and Treatment

Talwar, Abhinav; Morel, Karla Cruz; Perez, Vinicio de Jesus; Talwar, Arunabh

doi:10.21693/1933-088x-21.2.30

Cited by 2 publications

(1 citation statement)

References 48 publications

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“…To address the global disparities in TB follow-up care as well as global PH quality of care, scientific communities should consider testing and implementing improved, less expensive, and less invasive diagnostic methods 10 . Further, despite the negative impact demonstrated on quality of life after TB treatment, the effect of socioeconomic status (SES) on the disease process is not taken into account in current guidelines and management algorithms 23 .…”

Section: Impact On the Policy And Current Practicementioning

confidence: 99%

Effects of post tuberculosis lung disease on survival in HIV-infected individuals with pulmonary hypertension: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) study

Katoto,

Mukasa,

Wolmarans

et al. 2023

Preprint

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IntroductionPost-tuberculosis lung disease (PTLD) bears high mortality rates, primarily attributed to pulmonary vascular and cardiovascular complications. We investigated the impact of tuberculosis (TB) history on pulmonary hypertension (PH) prognosis within an HIV-burdened region.MethodsWe acquired sociodemographic, clinical, and echocardiographic data on 206 PH adults from the Pan African Pulmonary Hypertension cohort (PAPUCO), a prospective cohort study undertaken in four African countries. Cox-hazard regression models were constructed to assess how TB history interacts with diabetes, HIV-infection, and other chronic lung diseases (CLD), impacting death risks in PH patients.ResultsAmong the participants, a history of TB, diabetes, and other CLD was found in 23%, 8%, and 12% respectively. Of the 47 (35%)/134 participants living with HIV-infection, 62% exhibited HIV/TB coinfection, with 45% experiencing recurrent TB episodes. Individuals with TB history faced a 1.82-fold higher PH-related mortality risk (adjusted Hazard Ratio [aHR]: 1.84; 95%CI: 1.00, 3.39; p=0.049). Concurrent TB and comorbidities amplified death risks for PH patients, significantly affecting CLD (aHR: 3.10; 95%CI: 1.47, 6.53; p=0.003), and showing borderline impact for HIV co-infection (aHR: 2.10; 95%CI: 0.97, 4.54; p=0.059), while not significantly influenced by diabetes history (aHR: 2.39; 95%CI: 0.32, 18.00; p=0.4), although clinically relevant.ConclusionNearly one in every four patients diagnosed with PH in Africa have a history of TB and one in every three have HIV infection, which dramatically reduces their odds of survival. Our findings constitute a call to action to effectively address the neglected burden of PH among millions of patients suffering with TB diseases.

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Section: Impact On the Policy And Current Practicementioning

confidence: 99%

Effects of post tuberculosis lung disease on survival in HIV-infected individuals with pulmonary hypertension: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) study

Katoto,

Mukasa,

Wolmarans

et al. 2023

Preprint

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Global, Regional, and National Burden of Pulmonary Arterial Hypertension, 1990-2021: a Systematic Analysis of the Global Burden of Disease Study 2021

Deng,

Dong,

Qian

et al. 2024

Preprint

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Aims Pulmonary arterial hypertension (PAH) is a severe pulmonary vascular disease with high mortality rates. This research aimed to examine the disease burden of PAH including prevalence, incidence, mortality, and disability-adjusted life-years (DALYs) from 1990 to 2021 across various age groups, sexes, and Socio-demographic Index (SDI) levels, at global, regional and national levels. Methods Data was collected from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2021, which established models to estimate the burden of PAH for 204 countries and territories from 1990 to 2021. Age-standardized rates for PAH prevalence, incidence, mortality, and DALYs were calculated. Joinpoint regression was used to assess temporal trends. The correlation between disease burden and socioeconomic development was analyzed. Results In 2021, the global age-standardized prevalence and incidence rates were 2.28 and 0.52 per 100,000 population, respectively. From 1990 to 2021, the age-standardized mortality rate decreased from 0.35 to 0.27 per 100,000, with an average annual trend of -0.82%. The age-standardized DALY rate decreased from 13.21 to 8.24 per 100,000 by -1.52%. Females exhibited a higher incidence rate but lower mortality and DALY rates. The burden of PAH distributed unequally, with regions possessing higher socioeconomic statuses exhibiting lower mortality and DALY rates. Such inequalities have been improved over past decades. Conclusions The decline in mortality and DALY rates of PAH indicates improvements in disease management and patient outcomes, while the health inequalities among different regions and countries persist. Improving survival and life quality, and global health equality are crucial for future progress.

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The Impact of Socioeconomic, Racial, and Ethnic Disparities on Pulmonary Hypertension Diagnosis and Treatment

Cited by 2 publications

References 48 publications

Effects of post tuberculosis lung disease on survival in HIV-infected individuals with pulmonary hypertension: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) study

Effects of post tuberculosis lung disease on survival in HIV-infected individuals with pulmonary hypertension: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) study

Global, Regional, and National Burden of Pulmonary Arterial Hypertension, 1990-2021: a Systematic Analysis of the Global Burden of Disease Study 2021

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