Patients with pulmonary arterial hypertension had a significantly higher 12-month cumulative incidence of any new mental health condition compared to matched controls (39.5% vs 17.8%; HR 2.6; p<0.001).
Cohort (n=425,992)
Do patients with pulmonary arterial hypertension have an increased risk of developing mental health conditions compared to the general insured population?
Patients with pulmonary arterial hypertension have a significantly higher risk of developing mental health conditions compared to the general population, highlighting the need for routine mental health screening in this population.
Effect estimate: HR 2.6
Absolute Event Rate: 39.5% vs 17.8%
p-value: p=<0.001
Abstract Rationale Pulmonary arterial hypertension (PAH) is a chronic, life-threatening disease characterized by elevated pulmonary artery pressure that can lead to right heart failure. Emerging evidence suggests that patients with PAH may experience an increased risk of mental health (MH) conditions; however, robust real-world data quantifying this risk compared to patients without PAH remain limited. This study evaluates the incidence of newly-diagnosed MH conditions in a cohort of patients with PAH relative to a matched control population in the United States. Methods This retrospective cohort study utilized the Komodo Research Data administrative claims database from 01/01/2016-03/31/2024. Adults (≥18 years) with newly-diagnosed PAH were identified based on PAH-related ICD-10-CM diagnosis codes and PAH-targeted therapy claims. The index date was defined as the first observed PAH diagnosis. Controls were selected from the general insured population and were assigned a random index date. Both cohorts required ≥12 months of continuous baseline enrollment and ≥3 months of post-index follow-up. Cohorts were balanced using inverse probability weighting (IPW) based on demographics and the modified Quan-Charlson Comorbidity Index (QCCI). Time to incident MH diagnoses was evaluated using IP-weighted Cox proportional hazards models, and 12-month cumulative incidence and hazard ratios (HRs) were calculated. Results A total of 4,005 patients with PAH and 421,987 controls were included. After weighting, baseline characteristics were well balanced, with both cohorts having a weighted mean age of 61 years, 51% male, 44% enrolled in commercial insurance, and a median QCCI of 2. The 12-month cumulative incidence of any new MH condition was significantly higher in the PAH group (39.5%) compared to the control group (17.8%) (HR = 2.6; p 0.001). Relative risks were highest in the PAH cohort for sleep-wake disorders (23.3% vs 8.0%; HR = 3.2), suicidal ideation or self-harm (8.9% vs 3.8%; HR = 2.4), opioid use disorder (1.3% vs. 0.6%; HR = 2.3), and somatic symptom disorders (0.7% vs. 0.3%; HR = 2.1) (all p 0.001). The risks for anxiety spectrum and mood disorders were also significantly higher in the PAH cohort. No significant differences were observed in rates of neurodevelopmental, obsessive-compulsive, feeding/eating, and sexual-dysfunction disorders. Conclusions This study demonstrates that patients with PAH experience a significantly greater risk of developing a range of MH conditions compared to the general insured population. These findings underscore the importance of integrating multidisciplinary care teams, routine mental health screening, and access to psychiatric care within PAH management strategies. This abstract is funded by: Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA
Watzker et al. (Fri,) conducted a cohort in Pulmonary arterial hypertension (PAH) (n=425,992). Pulmonary arterial hypertension (exposure) vs. Matched control population was evaluated on Any new mental health condition (HR 2.6, p=<0.001). Patients with pulmonary arterial hypertension had a significantly higher 12-month cumulative incidence of any new mental health condition compared to matched controls (39.5% vs 17.8%; HR 2.6; p<0.001).
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