Abstract
Background
Older patients with pulmonary hypertension (PH) are more likely to have complex comorbidity
than younger patients with pulmonary arterial hypertension (PAH). The best approach
to the evaluation and management of these patients is unclear.
Methods
We, retrospectively, reviewed the clinical records of patients older than 60 years
referred for evaluation for PAH. We recorded patient demographics, comorbidity, functional
classification (FC), right heart catheterization data, echocardiographic data, chest
radiographic images and pulmonary function results. We recorded the final diagnoses
according to World Health Organization (WHO) subgroups and treatment outcomes based
on changes in FC.
Results
Ninety-seven records were reviewed in detail. The mean age was 71.2 ± 7.5 years with
66% women. Cardiovascular disease was the most frequent comorbidity. Mean PA pressure
by catheterization was 39.5 ± 12.2 mmHg (n = 65). The overall distribution after evaluation included 21 (21.6%) Group 1, 35
(36.1%) Group 2, 16 (16.5%) Group 3, 18 (18.6%) mixed Group 2 and 3, 6 (6.2%) Group
4 and 1 (1%) Group 5 patients. Group 1 patients were treated with PAH specific drug,
and 12 patients had an improvement in FC with treatment.
Conclusions
Older patients with suspected PH often have significant cardiovascular and respiratory
comorbidity. Comprehensive evaluations are needed to determine the severity of PH
and associated diseases and to initiate treatment focused on FC. Patients in WHO Group
2 and mixed Group 2 and 3 were frequently identified and constituted a diagnostic
and treatment challenge in this study. Older patients with PAH may benefit from PAH
specific drugs.
Key Indexing Terms
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Article info
Publication history
Published online: August 23, 2017
Accepted:
July 19,
2017
Received in revised form:
June 21,
2017
Received:
December 9,
2016
Footnotes
☆The authors have no financial or other conflicts of interest to disclose.
Identification
Copyright
© Published by on behalf of Southern Society for Clinical Investigation
