Clinical characteristics and causes of non-cardiac pulmonary hypertension in two major tertiary teaching hospitals in Ethiopia: a cross-sectional descriptive study

BACKGROUND: The development of pulmonary hypertension (PH) is a critical event in the prognosis of many cardiopulmonary diseases. There is a paucity of data with respect to non-cardiac PH in Ethiopia. Hence, this study aimed to describe the clinical characteristics of non-cardiac PH and identify common underlying pathologies by using echocardiography. METHODOLOGY: This cross-sectional descriptive study included patients with echocardiographic evidence of non-cardiac PH at Tikur Anbessa Specialized Hospital and St. Paul's Hospital Millennium Medical College between January 1, 2017, and June 30, 2022. A high probability of PH based on the 2015 ESC/ERS echocardiographic screening criteria was used to define positive cases. Data analysis was conducted using SPSS version 23. RESULTS: The study included 134 patients with non-cardiac PH, 67.9% of whom were female. The majority of participants (65.3%) were from urban areas, and three-quarters were in the age range between 30 and 70 years. Cough, fatigue, and/or peripheral edema were the main presentations (67%). The three most prevalent known risk factors identified for PH were a history of pulmonary tuberculosis (26.1%), use of biomass fuel for cooking (73.9%), and a history of deep vein thrombosis (12.7%). Post-tuberculosis pulmonary sequelae, interstitial lung diseases, and chronic obstructive pulmonary disease were the three most common underlying diseases identified in the study participants. CONCLUSIONS: A history of pulmonary tuberculosis and the use of biomass fuels for cooking were the two most common risk factors reported in patients with non-cardiac PH at two major tertiary teaching hospitals in Ethiopia. These findings highlight the need for further research to explore causal relationships and inform targeted public health interventions.