A study from the Centers for Disease Control and Prevention reveals that the number of deaths from pulmonary hypertension has increased over the past decade.
The research team, led by Dr. Mary George of the Division for Heart Disease and Stroke Prevention at the Centers for Disease Control and Prevention (CDC), recently published their findings online in CHEST - a journal of the American College of Chest Physicians.
Pulmonary hypertension, also known as pulmonary arterial hypertension, is a rare condition affecting 1 to 2 people in every 1 million over the US and Europe. Older women are at higher risk of the condition, but it can affect men and women of all ages.
It is characterized by high blood pressure in the pulmonary arteries, which carry oxygen and blood from the heart to the lungs. This means the right side of the heart has to work harder to pump blood around the body.
The condition typically occurs alongside other diseases, such as heart and blood vessel diseases, lung diseases and liver diseases. Pregnancy, sleep apnea, birth defects of the heart and certain autoimmune disorders, such as rheumatoid arthritis, are also common causes of pulmonary hypertension.
Symptoms of the condition include tiredness, chest pain, shortness of breath during routine activity, reduced appetite, a fast heartbeat and pain on the upper right side of the abdomen.
Research into the diagnosis and treatment of pulmonary hypertension is widening, according to the CDC investigators. Therefore, they say it is important to have up-to-date statistics on hospitalization and death rates from the condition.
Women and older people see largest increase in hospitalizations and death rates
For their study, the research team analyzed US pulmonary hypertension death and hospitalization rates between 2001 and 2010 using the National Vital Statistics System and data from the National Hospital Discharge Survey.
The greatest increase in hospitalizations as a result of pulmonary hypertension was found in women, who also saw the highest increase in death rates from the condition.
Results revealed that, during the 10-year period, death rates from pulmonary hypertension increased 2.5% per year for women and 0.9% per year for men. For individuals aged 85 years and over, death rates from the condition increased by more than 65%.
Around 4 in 10 pulmonary hypertension-related deaths occurred among patients aged 75 years or under, and death rates were around 40% higher for black patients than white patients.
Hospitalizations related to the condition increased 52% for women and 33% for men. Women accounted for 61% of all pulmonary hypertension hospitalizations between 2001 and 2002, and 63% of hospitalizations between 2009 and 2010.
At discharge from the hospital, congestive heart failure was found to be the most commonly reported prime diagnosis. Chronic and unspecified bronchitis and other heart diseases, including pulmonary hypertension, were the second most commonly reported diagnoses at discharge.
Pulmonary hypertension deaths as a result of autoimmune diseases increased over the 10-year period, a finding the team says warrants further research.
However, there was a decline in pulmonary hypertension mortality as a result of congenital malformations, chronic lower respiratory disease and emphysema during the study period, which they say is "encouraging."
Furthermore, Dr. George says the increase in hospitalizations could reflect both "improved recognition of pulmonary hypertension as well as an increase in treatment options."
Findings subject to limitations
The team notes that their findings are subject to several limitations. For example, they point out that death certificates of patients that were included in the data analysis may not accurately represent underlying or contributing causes of death. This could have lead to under-reporting of pulmonary hypertension.
Furthermore, the researchers say that the National Discharge Hospital Survey does not include patients admitted to federal, military or Veterans Affairs hospitals. "Therefore," they add, "results underestimate the total number of hospitalizations for pulmonary hypertension among adults."
The team also points out that the National Discharge Hospital Survey increased the number of diagnoses used in 2010 from seven to 15. They say this change can have a major influence over estimates, "particularly for conditions that are typically secondary diagnoses, such as pulmonary hypertension."
But overall, Dr. Richard S. Irwin, editor in chief of CHEST, says the study "illustrates the importance of recognizing and diagnosing pulmonary hypertension so patients can receive proper treatment."
"It is essential information to aid clinicians in understanding the age, race, and gender differences in patients who are at risk for pulmonary hypertension."