Mild pulmonary hypertension and premature mortality among 154 956 men and women undergoing routine echocardiography
Journal article
Stewart, Simon, Chan, Yih Kai, Playford, David and Strange, Geoffrey A.. (2022). Mild pulmonary hypertension and premature mortality among 154 956 men and women undergoing routine echocardiography. European Respiratory Journal. 59(1), pp. 1-13. https://doi.org/10.1183/13993003.00832-2021
Authors | Stewart, Simon, Chan, Yih Kai, Playford, David and Strange, Geoffrey A. |
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Abstract | Background Although mild pulmonary hypertension is known to be associated with increased mortality, its impact on premature mortality is largely unknown. Methods We studied the distribution of estimated right ventricular systolic pressure (eRVSP) among a total of 154 956 adults with no evidence of left heart disease investigated with echocardiography. We then examined individually linked mortality, premature mortality and associated life-years lost (LYL) according to eRVSP levels. Results The cohort comprised 70 826 men and 84 130 women (aged 61.3±17.7 and 61.4±18.4 years, respectively). Overall, 85 173 (55.0%), 49 276 (31.8%), 13 060 (8.4%) and 7447 (4.8%) cases had eRVSP levels indicative of no (<30.0 mmHg), mild (30.0–39.9 mmHg), moderate (40.0–49.9 mmHg) or severe (≥50.0 mmHg) pulmonary hypertension, respectively. During a median (interquartile range) 5.7 (3.2–8.9) years of follow-up, 38 456/154 986 (24.8%) individuals died. Compared with eRVSP <30.0 mmHg, age and sex-adjusted hazard ratios for all-cause and cardiovascular-related mortality were 1.90 (95% CI 1.84–1.96) and 1.85 (95% CI 1.74–1.97), respectively, for eRVSP 35.0–39.9 mmHg. Overall, 6256 (54%) men and 7524 (55%) women died prematurely. As a proportion of all deaths, premature mortality rose from 46.7% to 79.2% among those with eRVSP <30.0 versus ≥60.0 mmHg with a mean of 5.1–11.4 LYL each time. However, due to more individuals affected overall, eRVSP 30.0–39.9 mmHg accounted for 58% and 53% of total LYL among men (40 606/70 019 LYL) and women (47 333/88 568 LYL), respectively. Conclusions These data confirm that elevated eRVSP levels indicative of mild pulmonary hypertension are associated with increased risk of death. Moreover, this results in a substantive component of premature mortality/LYL that requires more proactive clinical surveillance and management. |
Year | 2022 |
Journal | European Respiratory Journal |
Journal citation | 59 (1), pp. 1-13 |
Publisher | European Respiratory Society |
ISSN | 0903-1936 |
Digital Object Identifier (DOI) | https://doi.org/10.1183/13993003.00832-2021 |
PubMed ID | 34049952 |
Scopus EID | 2-s2.0-85122369642 |
Open access | Published as green open access |
Page range | 1-13 |
Funder | Johnson & Johnson |
National Health and Medical Research Council (NHMRC) | |
Author's accepted manuscript | License All rights reserved File Access Level Open |
Publisher's version | License All rights reserved File Access Level Controlled |
Output status | Published |
Publication dates | |
Online | 31 Dec 2021 |
Publication process dates | |
Accepted | 16 May 2021 |
Deposited | 24 Mar 2023 |
Grant ID | GNT1135894 |
https://acuresearchbank.acu.edu.au/item/8yy10/mild-pulmonary-hypertension-and-premature-mortality-among-154-956-men-and-women-undergoing-routine-echocardiography
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File access level: Open |
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