Pulmonary Hypertension Is Associated With Systemic Arterial Hypertension Among Patients With Normal Left Ventricular Diastolic Function

Author:

Itelman Edward12ORCID,Segel Michael J.23,Kuperstein Rafael24,Feinberg Micha24ORCID,Segev Amit24,Segal Gad12ORCID,Maor Elad24ORCID,Grossman Ehud25ORCID

Affiliation:

1. Internal Medicine Ward “T” Chaim Sheba Medical Center Ramat Gan Israel

2. Sackler Faculty of Medicine Tel‐Aviv University Tel Aviv Israel

3. Department of Pulmonology Chaim Sheba Medical Center Ramat Gan Israel

4. Leviev Heart Center Chaim Sheba Medical Center Ramat Gan Israel

5. Internal Medicine Wing Chaim Sheba Medical Center Ramat Gan Israel

Abstract

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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