Pulmonary Hypertension in Central Australia

A Community-Based Cohort Study

Kawa Haji, Christopher X. Wong, Nikhil Chandra, Helen Truong, Wendy Corkill, Alex Kaethner, Pyi Naing, Asanga Abeyaratne, Stephen J. Brady, Nadarajah Kangaharan

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)598-604
    Number of pages7
    JournalHeart Lung and Circulation
    Volume28
    Issue number4
    Early online date6 Mar 2018
    DOIs
    Publication statusPublished - Apr 2019

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    Pulmonary Hypertension
    Cohort Studies
    Pulmonary Artery
    Blood Pressure
    Survival
    Life Expectancy
    Cardiovascular Diseases
    Survival Rate
    Mortality

    Cite this

    Haji, K., Wong, C. X., Chandra, N., Truong, H., Corkill, W., Kaethner, A., ... Kangaharan, N. (2019). Pulmonary Hypertension in Central Australia: A Community-Based Cohort Study. Heart Lung and Circulation, 28(4), 598-604. https://doi.org/10.1016/j.hlc.2018.02.020
    Haji, Kawa ; Wong, Christopher X. ; Chandra, Nikhil ; Truong, Helen ; Corkill, Wendy ; Kaethner, Alex ; Naing, Pyi ; Abeyaratne, Asanga ; Brady, Stephen J. ; Kangaharan, Nadarajah. / Pulmonary Hypertension in Central Australia : A Community-Based Cohort Study. In: Heart Lung and Circulation. 2019 ; Vol. 28, No. 4. pp. 598-604.
    @article{416ecc345ed44cb79a832c3810fad0cb,
    title = "Pulmonary Hypertension in Central Australia: A Community-Based Cohort Study",
    abstract = "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.",
    keywords = "Echocardiography, Indigenous Health, Pulmonary hypertension",
    author = "Kawa Haji and Wong, {Christopher X.} and Nikhil Chandra and Helen Truong and Wendy Corkill and Alex Kaethner and Pyi Naing and Asanga Abeyaratne and Brady, {Stephen J.} and Nadarajah Kangaharan",
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    Haji, K, Wong, CX, Chandra, N, Truong, H, Corkill, W, Kaethner, A, Naing, P, Abeyaratne, A, Brady, SJ & Kangaharan, N 2019, 'Pulmonary Hypertension in Central Australia: A Community-Based Cohort Study', Heart Lung and Circulation, vol. 28, no. 4, pp. 598-604. https://doi.org/10.1016/j.hlc.2018.02.020

    Pulmonary Hypertension in Central Australia : A Community-Based Cohort Study. / Haji, Kawa; Wong, Christopher X.; Chandra, Nikhil; Truong, Helen; Corkill, Wendy; Kaethner, Alex; Naing, Pyi; Abeyaratne, Asanga; Brady, Stephen J.; Kangaharan, Nadarajah.

    In: Heart Lung and Circulation, Vol. 28, No. 4, 04.2019, p. 598-604.

    Research output: Contribution to journalArticleResearchpeer-review

    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

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    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

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    Haji K, Wong CX, Chandra N, Truong H, Corkill W, Kaethner A et al. Pulmonary Hypertension in Central Australia: A Community-Based Cohort Study. Heart Lung and Circulation. 2019 Apr;28(4):598-604. https://doi.org/10.1016/j.hlc.2018.02.020