Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function
Background The association of pulmonary and systemic arterial hypertension is believed to be mediated through hypertensive left heart disease. The purpose of the current study was to investigate whether pulmonary hypertension (PHT) is associated with systemic arterial hypertension among patients wit...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.023603 |
| _version_ | 1797945427799048192 |
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| author | Edward Itelman Michael J. Segel Rafael Kuperstein Micha Feinberg Amit Segev Gad Segal Elad Maor Ehud Grossman |
| author_facet | Edward Itelman Michael J. Segel Rafael Kuperstein Micha Feinberg Amit Segev Gad Segal Elad Maor Ehud Grossman |
| author_sort | Edward Itelman |
| collection | DOAJ |
| description | Background The association of pulmonary and systemic arterial hypertension is believed to be mediated through hypertensive left heart disease. The purpose of the current study was to investigate whether pulmonary hypertension (PHT) is associated with systemic arterial hypertension among patients with apparently normal left ventricular diastolic function. Methods and Results Consecutive patients who had echocardiographic evaluation between 2007 and 2019 were enrolled. Patients with disease states that are known to be associated with PHT, including diastolic dysfunction, were excluded from the analysis. Estimated right ventricular systolic pressure was extracted for all patients from the echocardiographic reports. PHT was defined as estimated right ventricular systolic pressure >40 mm Hg. Multivariate logistic regression models were applied. Final study population included 25 916 patients with a median age of 59 (interquartile range, 44–69) years, of whom 12 501 (48%) were men and 13 265 (51%) had systemic arterial hypertension. Compared with normotensive patients, hypertensive patients were 3.2 times more likely to have PHT (95% CI, 2.91–3.53; P<0.001). A multivariate model adjusted for clinical and echocardiographic parameters that are known to be associated with PHT demonstrated that hypertensive patients are almost 3 times more likely to have PHT (95% CI, 2.45–3.15; P<0.001). The association was significant in multiple subgroups but was more significant among women compared with men (odds ratio, 3.1 versus 2.4; P for interaction <0.001). Conclusions PHT is associated with systemic arterial hypertension irrespective of left heart disease. The association is more pronounced among women. |
| first_indexed | 2024-04-10T20:54:58Z |
| format | Article |
| id | doaj.art-c22ef02e7a05421cb8b3f63d210496c9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T20:54:58Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c22ef02e7a05421cb8b3f63d210496c92023-01-23T07:23:59ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-12-01102410.1161/JAHA.121.023603Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic FunctionEdward Itelman0Michael J. Segel1Rafael Kuperstein2Micha Feinberg3Amit Segev4Gad Segal5Elad Maor6Ehud Grossman7Internal Medicine Ward “T” Chaim Sheba Medical Center Ramat Gan IsraelSackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelSackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelSackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelSackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelInternal Medicine Ward “T” Chaim Sheba Medical Center Ramat Gan IsraelSackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelSackler Faculty of Medicine Tel‐Aviv University Tel Aviv IsraelBackground The association of pulmonary and systemic arterial hypertension is believed to be mediated through hypertensive left heart disease. The purpose of the current study was to investigate whether pulmonary hypertension (PHT) is associated with systemic arterial hypertension among patients with apparently normal left ventricular diastolic function. Methods and Results Consecutive patients who had echocardiographic evaluation between 2007 and 2019 were enrolled. Patients with disease states that are known to be associated with PHT, including diastolic dysfunction, were excluded from the analysis. Estimated right ventricular systolic pressure was extracted for all patients from the echocardiographic reports. PHT was defined as estimated right ventricular systolic pressure >40 mm Hg. Multivariate logistic regression models were applied. Final study population included 25 916 patients with a median age of 59 (interquartile range, 44–69) years, of whom 12 501 (48%) were men and 13 265 (51%) had systemic arterial hypertension. Compared with normotensive patients, hypertensive patients were 3.2 times more likely to have PHT (95% CI, 2.91–3.53; P<0.001). A multivariate model adjusted for clinical and echocardiographic parameters that are known to be associated with PHT demonstrated that hypertensive patients are almost 3 times more likely to have PHT (95% CI, 2.45–3.15; P<0.001). The association was significant in multiple subgroups but was more significant among women compared with men (odds ratio, 3.1 versus 2.4; P for interaction <0.001). Conclusions PHT is associated with systemic arterial hypertension irrespective of left heart disease. The association is more pronounced among women.https://www.ahajournals.org/doi/10.1161/JAHA.121.023603diastolic dysfunctionpulmonary hypertensionsystemic arterial hypertension |
| spellingShingle | Edward Itelman Michael J. Segel Rafael Kuperstein Micha Feinberg Amit Segev Gad Segal Elad Maor Ehud Grossman Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease diastolic dysfunction pulmonary hypertension systemic arterial hypertension |
| title | Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function |
| title_full | Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function |
| title_fullStr | Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function |
| title_full_unstemmed | Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function |
| title_short | Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function |
| title_sort | pulmonary hypertension is associated with systemic arterial hypertension among patients with normal left ventricular diastolic function |
| topic | diastolic dysfunction pulmonary hypertension systemic arterial hypertension |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.023603 |
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