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. 2013 Dec 16;8(12):e84264.
doi: 10.1371/journal.pone.0084264. eCollection 2013.

Prevalence and clinical characteristics associated with pulmonary hypertension in African-Americans

Gaurav Choudhary  1 , Matthew Jankowich  1 , Wen-Chih Wu  1
Affiliations

Prevalence and clinical characteristics associated with pulmonary hypertension in African-Americans

Gaurav Choudhary et al. PLoS One. .

Abstract

Background: Pulmonary 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.

Methods: We 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.

Results: The 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.

Conclusions: Pulmonary 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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Distribution of trans-tricuspid gradients in study cohort.
Vertical line indicates a gradient of 35 mm of Hg that was used as a cut-off for definition of pulmonary hypertension.
Figure 2
Figure 2. Prevalence of pulmonary hypertension based on age groups and gender.
See this image and copyright information in PMC

References

    1. Lam CSP, Borlaug BA, Kane GC, Enders FT, Rodeheffer RJ et al. (2009) Age-associated increases in pulmonary artery systolic pressure in the general population. Circulation 119: 2663-2670. doi:10.1161/CIRCULATIONAHA.108.838698. PubMed: 19433755. - DOI - PMC - PubMed
    1. Strange G, Playford D, Stewart S, Deague JA, Nelson H et al. (2012) Pulmonary hypertension: prevalence and mortality in the Armadale echocardiography cohort. Heart 98: 1805-1811. doi:10.1136/heartjnl-2012-301992. PubMed: 22760869. - DOI - PMC - PubMed
    1. Abramson SV, Burke JF, Kelly JJ Jr., Kitchen JG 3rd, Dougherty MJ et al. (1992) Pulmonary hypertension predicts mortality and morbidity in patients with dilated cardiomyopathy. Ann Intern Med 116: 888-895. doi:10.7326/0003-4819-116-11-888. PubMed: 1580444. - DOI - PubMed
    1. Ghio S, Gavazzi A, Campana C, Inserra C, Klersy C et al. (2001) Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol 37: 183-188. doi:10.1016/S0735-1097(01)80003-6. PubMed: 11153735. - DOI - PubMed
    1. Kjaergaard J, Akkan D, Iversen KK, Kjoller E, Køber L et al. (2007) Prognostic importance of pulmonary hypertension in patients with heart failure. Am J Cardiol 99: 1146-1150. doi:10.1016/j.amjcard.2006.11.052. PubMed: 17437745. - DOI - PubMed

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