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Causes of Pulmonary Hypertension in the Elderly
Causes of Pulmonary Hypertension in the Elderly
- Source :
- Chest. 146:159-166
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- BACKGROUND Pulmonary hypertension (PH) is common in elderly patients, but a detailed analysis of the causes of PH in the elderly has not been performed. We hypothesized that pulmonary arterial hypertension (PAH) is rare in elderly patients and sought to describe the characteristics of these patients at a large referral center. METHODS Clinical and hemodynamic data were collected on consecutive patients ≥ 65 years of age referred for evaluation of PH. The subtype of PH was determined after standard evaluation using the World Health Organization (WHO) classification. Patients with PH not meeting criteria for PAH with "out-of-proportion" PH related to group 2 or group 3 disease were classified as "other/mixed PH." A model using age, presence of connective tissue disease, and left atrial size was developed to predict the probability of PAH diagnosis. RESULTS Two hundred forty-six elderly patients were evaluated (mean age, 72.9 ± 5.5 years, 78% women); 36 had PAH (15%). Idiopathic PAH was rare (four patients, 1.6%). WHO group 2 PH was the most frequent diagnosis (n = 70, 28% of cohort); mixed/other PH (n = 43, 17%) and WHO group 3 PH (n = 34, 14%) were also common diagnoses. Connective tissue disease strongly predicted PAH diagnosis (OR, 27.2; 95% CI, 9.5-77.6). CONCLUSIONS PAH is an uncommon cause of PH in elderly patients, most frequently associated with connective tissue disease. WHO group 2 PH and mixed disease are common, highlighting a need for careful phenotyping of elderly patients with PH prior to initiating PAH therapy.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Hypertension, Pulmonary
Hemodynamics
Critical Care and Intensive Care Medicine
Risk Assessment
Risk Factors
Internal medicine
medicine
Humans
Pulmonary Wedge Pressure
Pulmonary wedge pressure
Aged
Retrospective Studies
Original Research
business.industry
Incidence
Incidence (epidemiology)
Age Factors
Retrospective cohort study
medicine.disease
Pulmonary hypertension
Connective tissue disease
United States
Cohort
Cardiology
Female
Cardiology and Cardiovascular Medicine
Heart failure with preserved ejection fraction
business
Subjects
Details
- ISSN :
- 00123692
- Volume :
- 146
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi.dedup.....ffd790d59323a4cc57f80dd91673b9e7
- Full Text :
- https://doi.org/10.1378/chest.13-1900