title: Appetite-suppressant drugs and the risk of primary pulmonary hypertension. International Primary Pulmonary Hypertension Study Group.
abstract: BACKGROUND
  Recently, a cluster of patients was observed in France in whom primary pulmonary hypertension developed in patients exposed to derivatives of fenfluramine in appetite suppressants (anorexic agents), which are used for weight control. We investigated the potential role of anorexic agents and other suspected risk factors for primary pulmonary hypertension.
  
  
  METHODS
  In a case-control study, we assessed 95 patients with primary pulmonary hypertension from 35 centers in France, Belgium, the United Kingdom, and the Netherlands and 355 controls recruited from general practices and matched to the patients' sex and age.
  
  
  RESULTS
  The use of anorexic drugs (mainly derivatives of fenfluramine) was associated with an increased risk of primary pulmonary hypertension (odds ratio with any anorexic-drug use, 6.3; 95 percent confidence interval, 3.0 to 13.2). For the use of anorexic agents in the preceding year, the odds ratio was 10.1 (95 percent confidence interval, 3.4 to 29.9). When anorexic drugs were used to a total of more than three months, the odds ratio was 23.1 (95 percent confidence interval, 6.9 to 77.7). We also confirmed an association with several previously identified risk factors: a family history of pulmonary hypertension, infection with the human immunodeficiency virus, cirrhosis, and use of cocaine or intravenous drugs.
  
  
  CONCLUSIONS
  The use of anorexic drugs was associated with the development of primary pulmonary hypertension. Active surveillance for this disease should be considered, particularly since their use is expected to increase in the near future.
authors.affiliation: Centre for Clinical Epidemiology and Community Studies, McGill University, Montreal, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Abenhaim
authors.forename: Y
authors.initials: Y
authors.lastname: Moride
authors.forename: F
authors.initials: F
authors.lastname: Brenot
authors.forename: S
authors.initials: S
authors.lastname: Rich
authors.forename: J
authors.initials: J
authors.lastname: Benichou
authors.forename: X
authors.initials: X
authors.lastname: Kurz
authors.forename: T
authors.initials: T
authors.lastname: Higenbottam
authors.forename: C
authors.initials: C
authors.lastname: Oakley
authors.forename: E
authors.initials: E
authors.lastname: Wouters
authors.forename: M
authors.initials: M
authors.lastname: Aubier
authors.forename: G
authors.initials: G
authors.lastname: Simonneau
authors.forename: B
authors.initials: B
authors.lastname: Bégaud
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001067:Appetite Depressants / Q000009:adverse effects*; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D005277:Fenfluramine / Q000009:adverse effects*; D005602:France / Q000453:epidemiology; D006334:Heart Function Tests; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced* / Q000453:epidemiology / Q000503:physiopathology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001067:Appetite Depressants; D005277:Fenfluramine