Key result
Black race was associated with higher pulmonary artery systolic pressure (β 0.94; 95% CI 0.24-1.64; P=0.009), but this association was no longer significant after adjusting for lung volume.
Cohort (n=1,311)
In a middle-aged biracial cohort, higher echocardiographically estimated PASP was associated with insulin resistance, inflammation, and diastolic dysfunction, while the association with Black race was attenuated by lung volume.
Background The determinants of pulmonary artery systolic pressure ( PASP ) are not fully understood. It is unknown whether racial differences in PASP exist or if other population characteristics are associated with pulmonary pressure in humans. We examined echocardiographically estimated PASP in the Coronary Artery Risk Development in Young Adults ( CARDIA ) study, a middle‐aged, biracial community‐based cohort. Methods and Results At the CARDIA year‐25 examination, 3469 participants underwent echocardiography, including measurement of tricuspid regurgitant jet velocity to estimate PASP . Clinical features, laboratory values, pulmonary function tests, and measurement of adipose depot volume were analyzed for association with PASP . PASP was estimated in 1311 individuals (61% female, 51% white). Older age, higher blood pressure, and higher body mass index were associated with higher PASP . Black race was associated with higher PASP after adjustment for demographics and left and right ventricular function (β 0.94, 95% CI 0.24‐1.64; P =0.009), but this association was no longer significant after further adjustment for lung volume (β 0.42, 95% CI −0.68 to 0.96; P =0.74). Insulin resistance, inflammation (C‐reactive protein and interleukin‐6), and visceral adipose volume were independently associated with higher PASP after adjustment for relevant covariates. PASP rose with worsening diastolic function (ratio of early transmitral Doppler velocity to average mitral annular tissue Doppler velocity [E/e′] and left atrial volume index). Conclusions In a large biracial cohort of middle‐aged adults, we identified associations among black race, insulin resistance, and diastolic dysfunction with higher echocardiographically estimated PASP . Further studies are needed to examine racial differences in PASP and whether insulin resistance directly contributes to pulmonary vascular disease in humans.
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Brittain et al. (2017) conducted a cohort in General population (n=1,311). Black race vs. White race was evaluated on Echocardiographically estimated pulmonary artery systolic pressure (PASP) (β 0.94, 95% CI 0.24-1.64, p=0.009). Black race was associated with higher pulmonary artery systolic pressure (β 0.94; 95% CI 0.24-1.64; P=0.009), but this association was no longer significant after adjusting for lung volume.
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