Document Detail


Unexplained severe pulmonary hypertension in the elderly: report on 14 patients.
MedLine Citation:
PMID:  14986462     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Unexplained pulmonary hypertension is assumed to occur mainly in young adults. OBJECTIVE: To describe the features of the disease in older patients and compare them to those in PHT patients of all ages. METHODS: We conducted a retrospective evaluation of the files of patients over 65 years of age in whom UPHT was diagnosed between 1987 and 1999 at two PHT centers serving a population of 4 million. Patients were followed for survival until March 2003. Clinical variables of the study patients were compared with those in PHT patients of all ages. RESULTS: The study group included 14 patients, 10 females and four males, with a mean age of 70.5 +/- 6.7 years. The calculated mean annual incidence of UPHT for the study population was one new case per year per million persons. Seven patients (50%) had systemic hypertension. The mean interval from onset of symptoms to diagnosis was 8.3 months. At diagnosis, 64% of patients had functional capacity of III-IV according to the New York Heart Association classification, and 43% had right heart failure. Mean systolic pulmonary artery pressure was 80 +/- 21 mmHg, peripheral vascular resistance 11.7 +/- 7 mmHg/L/min, cardiac index 2.16 +/- 0.81, and mean right atrial pressure 10.5 +/- 5.9 mmHg. Median survival time was 43 months; survival rates for 1 year, 3 years and 5 years were 92.6%, 50% and 40%, respectively. Compared to data from the U.S. National Institute of Health Registry, UPHT in older patients is more common in females, but the incidence as well as clinical, hemodynamic and survival parameters are similar to those in PHT patients at any age. CONCLUSIONS: UPHT occurs in the elderly more frequently than previously thought, with similar features in PHT patients of all ages. The coexistence of systemic and pulmonary hypertension warrants further investigation.
Authors:
Mordechai Yigla; Mordechai R Kramer; Daniele Bendayan; Shimon A Reisner; Anna Solomonov
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  6     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-27     Completed Date:  2004-03-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  78-81     Citation Subset:  IM    
Affiliation:
Division of Pulmonary Medicine, Department of Cardiology, Rambam Medical Center, Haifa, Israel. m_yigla@rambam.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Humans
Hypertension, Pulmonary / diagnosis,  drug therapy,  epidemiology*,  physiopathology
Incidence
Israel / epidemiology
Male
Retrospective Studies
Comments/Corrections
Comment In:
Isr Med Assoc J. 2004 Apr;6(4):255; author reply 255   [PMID:  15115271 ]

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