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. 2015 Jun 23;10(6):e0130072.
doi: 10.1371/journal.pone.0130072. eCollection 2015.

Prevalence of Pulmonary Hypertension in the General Population: The Rotterdam Study

Eduardo M Moreira  1 , Henning Gall  2 , Maarten J G Leening  3 , Lies Lahousse  4 , Daan W Loth  5 , Bouwe P Krijthe  6 , Jessica C Kiefte-de Jong  6 , Guy G Brusselle  7 , Albert Hofman  6 , Bruno H Stricker  8 , Hossein A Ghofrani  2 , Oscar H Franco  6 , Janine F Felix  6
Affiliations

Prevalence of Pulmonary Hypertension in the General Population: The Rotterdam Study

Eduardo M Moreira et al. PLoS One. .

Abstract

Background: Pulmonary hypertension is characterized by increased pulmonary artery pressure and carries an increased mortality. Population-based studies into pulmonary hypertension are scarce and little is known about its prevalence in the general population. We aimed to describe the distribution of echocardiographically-assessed pulmonary artery systolic pressure (ePASP) in the general population, to estimate the prevalence of pulmonary hypertension, and to identify associated factors.

Methods: Participants (n = 3381, mean age 76.4 years, 59% women) from the Rotterdam Study, a population-based cohort, underwent echocardiography. Echocardiographic pulmonary hypertension was defined as ePASP>40 mmHg.

Results: Mean ePASP was 26.3 mmHg (SD 7.0). Prevalence of echocardiographic pulmonary hypertension was 2.6% (95%CI: 2.0; 3.2). Prevalence was higher in older participants compared to younger ones (8.3% in those over 85 years versus 0.8% in those between 65 and 70), and in those with underlying disorders versus those without (5.9% in subjects with COPD versus 2.3%; 9.2% in those with left ventricular systolic dysfunction versus 2.3%; 23.1% in stages 3 or 4 left ventricular diastolic dysfunction versus 1.9% in normal or stage 1). Factors independently associated with higher ePASP were older age, higher BMI, left ventricular diastolic dysfunction, COPD and systemic hypertension.

Conclusion: In this large population-based study, we show that pulmonary hypertension as measured by echocardiography has a low prevalence in the overall general population in the Netherlands, but estimates may be higher in specific subgroups, especially in those with underlying diseases. Increased pulmonary arterial pressure is likely to gain importance in the near future due to population aging and the accompanying prevalences of underlying disorders.

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Conflict of interest statement

Competing Interests: The authors have the following interests: JCK-dJ and OHF work in ErasmusAGE, a center for aging research across the life course funded by Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA. H.G. has received support and/or honoraria from Actelion, AstraZeneca, Bayer, GlaxoSmithKline, Janssen Cilag, Lilly, Pfizer, and United Therapeutics/OMT. H.A.G. reports personal fees from Actelion, Bayer, Ergonex, Gilead, GSK, Merck, Novartis, Pfizer and grants from Actelion, Bayer, Ergonex, Pfizer outside the submitted work. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Distribution of pulmonary artery systolic pressure in 1945 participants in whom it could be estimated.
See this image and copyright information in PMC

References

    1. Galie N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J. 2009;30(20):2493–537. Epub 2009/08/29. 10.1093/eurheartj/ehp297 . - DOI - PubMed
    1. McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol. 2009;53(17):1573–619. Epub 2009/04/25. 10.1016/j.jacc.2009.01.004 . - DOI - PubMed
    1. Hatano S, Strasser T, World Health Organisation. Primary pulmonary hypertension: report on a WHO meeting. Geneva 1975. Available: http://www.who.int/iris/handle/10665/39094
    1. Appelbaum L, Yigla M, Bendayan D, Reichart N, Fink G, Priel I, et al. Primary pulmonary hypertension in Israel: a national survey. Chest. 2001;119(6):1801–6. Epub 2001/06/16. . - PubMed
    1. Simonneau G, Robbins IM, Beghetti M, Channick RN, Delcroix M, Denton CP, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S43–54. Epub 2009/07/09. 10.1016/j.jacc.2009.04.012 . - DOI - PubMed

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