TY - JOUR
T1 - Pulmonary Hypertension in Central Australia
T2 - A Community-Based Cohort Study
AU - Haji, Kawa
AU - Wong, Christopher X.
AU - Chandra, Nikhil
AU - Truong, Helen
AU - Corkill, Wendy
AU - Kaethner, Alex
AU - Naing, Pyi
AU - Abeyaratne, Asanga
AU - Brady, Stephen J.
AU - Kangaharan, Nadarajah
PY - 2019/4
Y1 - 2019/4
N2 - Background: The burden of pulmonary hypertension (PHT) in Central Australia has not been previously studied. Our aim is to characterise the prevalence, clinical classification, and long-term survival of individuals with PHT in Central Australia. Methods: A community-based cohort study of all individuals diagnosed with PHT in Central Australia between 2005 and 2016 was undertaken. We estimated PHT prevalence using population data, describe clinical PHT classification, and characterised long-term survival using Kaplan-Meier approaches. Results: A total of 183 patients were identified (mean age 52 ± 16 years, 63% female). Of these individuals, 149 (81.4%) were of Aboriginal and Torres Strait Islander (ATSI) descent. The prevalence per 100,000 of any PHT was significantly higher In ATSI (723 [95% CI 608–839] compared to non-ATSI individuals (126 [95% CI 84–168], p < 0.001). Furthermore, ATSI individuals were diagnosed at younger ages compared to non-ATSI individuals (49 ± 15 vs 64 ± 16 years, p < 0.001). Median estimated pulmonary artery systolic pressure (ePASP) was higher in patients with pulmonary arterial hypertension (PAH) compared to other causes (62 [IQR 54–69] vs 50 [IQR 44–58] mmHg, p < 0.01). The median survival rate from diagnosis was 9 years (IQR 7.2–13.2). Age and ePASP were significant predictors of mortality (HR 1.05 [95% CI 1.02–1.07] and HR 1.56 [95% 1.00–2.42] respectively). Conclusions: In this community based study, we found a high burden of PHT in Central Australia. The prevalence of PHT is greater in ATSI individuals and is diagnosed at younger ages compared to non-ATSI individuals. Together with other cardiovascular diseases, PHT may be in-part contributing to the gap in life expectancy between ATSI and non-ATSI individuals.
AB - Background: The burden of pulmonary hypertension (PHT) in Central Australia has not been previously studied. Our aim is to characterise the prevalence, clinical classification, and long-term survival of individuals with PHT in Central Australia. Methods: A community-based cohort study of all individuals diagnosed with PHT in Central Australia between 2005 and 2016 was undertaken. We estimated PHT prevalence using population data, describe clinical PHT classification, and characterised long-term survival using Kaplan-Meier approaches. Results: A total of 183 patients were identified (mean age 52 ± 16 years, 63% female). Of these individuals, 149 (81.4%) were of Aboriginal and Torres Strait Islander (ATSI) descent. The prevalence per 100,000 of any PHT was significantly higher In ATSI (723 [95% CI 608–839] compared to non-ATSI individuals (126 [95% CI 84–168], p < 0.001). Furthermore, ATSI individuals were diagnosed at younger ages compared to non-ATSI individuals (49 ± 15 vs 64 ± 16 years, p < 0.001). Median estimated pulmonary artery systolic pressure (ePASP) was higher in patients with pulmonary arterial hypertension (PAH) compared to other causes (62 [IQR 54–69] vs 50 [IQR 44–58] mmHg, p < 0.01). The median survival rate from diagnosis was 9 years (IQR 7.2–13.2). Age and ePASP were significant predictors of mortality (HR 1.05 [95% CI 1.02–1.07] and HR 1.56 [95% 1.00–2.42] respectively). Conclusions: In this community based study, we found a high burden of PHT in Central Australia. The prevalence of PHT is greater in ATSI individuals and is diagnosed at younger ages compared to non-ATSI individuals. Together with other cardiovascular diseases, PHT may be in-part contributing to the gap in life expectancy between ATSI and non-ATSI individuals.
KW - Echocardiography
KW - Indigenous Health
KW - Pulmonary hypertension
UR - http://www.scopus.com/inward/record.url?scp=85044270547&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2018.02.020
DO - 10.1016/j.hlc.2018.02.020
M3 - Article
C2 - 29599030
AN - SCOPUS:85044270547
SN - 1443-9506
VL - 28
SP - 598
EP - 604
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 4
ER -