Key result
Diastolic dysfunction (β=-13.06, p=0.006), higher BMI (β=-1.09, p<0.0001), and smoking (β=-3.42, p=0.001) were significantly associated with pulmonary hypertension in young adults.
Observational (n=4,171)
In young adults, pulmonary hypertension assessed by echocardiography is relatively common and is associated with modifiable risk factors including obesity, physical inactivity, and smoking, as well as diastolic dysfunction.
May support risk factor assessment in young adults with diastolic dysfunction; extends associations to this group but leaves causality open.
BACKGROUND: Risk factors of pulmonary hypertension (PH) are poorly understood. The objective of this study was to identify the determinants of PH in young adults. METHODS: We analysed a limited access dataset from the CARDIA (Coronary Artery Risk Development in Young Adults) study provided by the National Heart, Lung and Blood Institute. Pulmonary arterial pressure was assessed by the Doppler pulmonary artery acceleration time (PAAT). Socio-demographic characteristics, self-reported clinical variables, echocardiographic variables, pulmonary function tests, systemic blood pressure and body mass index calculated from height and weight were used in multivariate analysis. RESULTS: There were 4171 study subjects, mean age 24.9 ± 3.6 years, retained in year five with echocardiographic data available after five years of follow-up. The prevalence of severe PH (PAAT ≤ 70 ms) and mild to moderate PH (PAAT = 109.9-70.01 ms) was 1.1% and 14% respectively. Multivariate analysis revealed that body mass index (β = -1.09, p < 0.0001), female gender (β = 6.25, p < 0.0001), age (β = -0.30, p = 0.02), African American race (β = -2.57, p = 0.007), physical activity (β = 0.005, p = 0.002), current smoking (β = -3.42, p = 0.001), left atrial dimension (β = -2.97, p = 0.009) and diastolic dysfunction (β = -13.06, p = 0.006) were statistically significant variables predicting PH. CONCLUSION: In this large, observational study of young adults, pulmonary hypertension, as assessed by echocardiography, is common. Diastolic dysfunction, obesity, physical inactivity and smoking are associated with elevated pulmonary arterial pressure in young adults.
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Guglin et al. (2012) conducted an observational in Pulmonary hypertension (n=4,171). Diastolic dysfunction (β=-13.06, p=0.006), higher BMI (β=-1.09, p<0.0001), and smoking (β=-3.42, p=0.001) were significantly associated with pulmonary hypertension in young adults.
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