Sex-based differences in veterans with pulmonary hypertension: Results from the veterans affairs-clinical assessment reporting and tracking database
Year: 2017
Type: article
Study design: Observational Study
Abstract: Women have an increased risk of pulmonary hypertension (PH) but better survival compared to men. Few studies have explored sex-based differences in population-based cohorts with PH. We sought to determine whether sex was associated with hemodynamics and survival in US veterans with PH (mean pulmonary artery pressure [mPAP] ≥ 25 mm Hg) from the Veterans Affairs Clinical Assessment, Reporting, and Tracking database. The relationship between sex and hemodynamics was assessed with multivariable linear mixed modeling. Cox proportional hazards models were used to compare survival by sex for those with PH and precapillary PH (mPAP ≥ 25 mm Hg, pulmonary artery wedge pressure [PAWP] ≤ 15 mm Hg and pulmonary vascular resistance [PVR] > 3 Wood units) respectively. The study population included 15,464 veterans with PH, 516 (3%) of whom were women; 1,942 patients (13%) had precapillary PH, of whom 120 (6%) were women. Among those with PH, women had higher PVR and pulmonary artery pulse pressure, and lower right atrial pressure and PAWP (all p <0.001) compared with men. There were no significant differences in hemodynamics according to sex in veterans with precapillary PH. Women with PH had 18% greater survival compared to men with PH (adjusted HR 0.82, 95% CI 0.69-0.97, p = 0.020). Similarly, women with precapillary PH were 29% more likely to survive as compared to men with PH (adjusted HR 0.71, 95% CI 0.52-0.98, p = 0.040). In conclusion, female veterans with PH have better survival than males despite higher pulmonary afterload.
Source: PLoS ONE
Institutions: Brown University, VA Eastern Colorado Health Care System, Vanderbilt University, Richard L. Roudebush VA Medical Center, Indiana University Indianapolis, Indiana University School of Medicine, Indiana University – Purdue University Indianapolis, University of Colorado Anschutz, Stanford Medicine, Stanford University, Providence VA Medical Center, Brigham and Women's Hospital, Harvard University, VA Boston Healthcare System
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Funders: U.S. Department of Veterans Affairs, American Heart Association, Eli Lilly and Company, Brigham and Women's Hospital, Gilead Sciences, United Therapeutics Corporation, Acceleron, Cardiovascular Medical Research and Education Fund, National Institutes of Health, Genentech, National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences
Awards: G1779042679, CardioPulmonary Vascular Biology COBRE, G2185488700, G2365086108, G279722841, Network Analysis: NEDD9 regulates maladaptive vascular fibrosis to promote pulmonary arterial hypertension, G3445634850, Aldosterone impairs endothelin B-dependent synthesis of nitric oxide to promote p, Nicotinic Acetylcholine Receptors and RV Dysfunction in Pulmonary Hypertension, G5573239154, Hypoxia-mediated protective estrogen receptor signaling in pulmonary hypertension, G686247023, G8272672485, G8346347604, Targeting FAK-NEDD9 protein-protein interaction to prevent focal adhesion assembly and vascular proliferation in pulmonary arterial hypertension
OpenAlex ID: W2767800527