Key result
Non-Hispanic Black PAH patients present with more severe disease and delayed catheterization vs non-Black patients.
Why the study?
Awareness of health disparities across racial and ethnic groups is essential to improve care in pulmonary arterial hypertension, prompting investigation into differences in clinical characteristics and disease severity at diagnosis.
Are there differences in clinical characteristics, illness severity, and diagnostic delays at the time of PAH diagnosis between non-Hispanic Black and non-Black patients?
Cohort (n=110)
No
Are there differences in clinical characteristics, illness severity, and diagnostic delays at the time of PAH diagnosis between non-Hispanic Black and non-Black patients?
Non-Hispanic Black patients with PAH face significant health disparities, presenting with more severe disease at diagnosis and experiencing longer delays in diagnostic testing.
Disparities in PAH severity and diagnostic delays among non-Hispanic Black patients warrant attention; hypothesis-generating for equity-focused interventions.
Awareness of health disparities that exist across different self-identified racial and ethnic groups are essential to developing interventions that improve the quality of care of patients with rare diseases such as pulmonary arterial hypertension (PAH). We sought to determine whether there are important differences in clinical characteristics and illness severity at the time of PAH diagnosis among different racial/ethnic groups. 110 patients followed at the University of Illinois Health Pulmonary Hypertension Clinic diagnosed with PAH between 2010 and 2019 were enrolled in our retrospective cohort study. Self-reported race, ethnicity, ZIP code, and standard clinical measures were obtained from the electronic medical record. Comparisons of clinical severity, hemodynamic measurements, social vulnerability, income, and timing of diagnostic testing were made between non-Hispanic Black and non-Black subjects. Our data shows that PAH is more severe at the time of diagnosis in non-Hispanic Black patients compared to non-Black patients, by both clinical and hemodynamic assessments. Tricuspid regurgitant velocity correlated poorly with invasive hemodynamics in non-Hispanic Black patients, yet measures of RV performance were worse than non-Black counterparts. Increased social vulnerability and income inequality was evident between the groups. When compared to non-Black patients, there were significant delays between abnormal echocardiogram findings and completion of diagnostic catheterization. These results implicate concerning health disparities in non-Hispanic Black patients with PAH. More severe disease at time of diagnosis and longer delays from time of symptom onset to PAH diagnosis have both been associated with increased mortality in this population and future work should be aimed at comprehensive strategies to reduce this disparity.
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Holbert et al. (2025) conducted a cohort in Pulmonary Arterial Hypertension (n=110). Non-Hispanic Black race/ethnicity vs. Non-Black race/ethnicity was evaluated on Clinical severity, hemodynamic measurements, and timing of diagnostic testing at PAH diagnosis. Non-Hispanic Black patients with PAH presented with more severe clinical and hemodynamic disease at diagnosis and faced significant delays to diagnostic catheterization compared to non-Black patients.
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