title: Prevalence and clinical characteristics associated with pulmonary hypertension in African-Americans.
abstract: BACKGROUND
  Pulmonary hypertension (PH) is associated with increased mortality and morbidity. It is frequently associated with cardiopulmonary diseases that are prevalent in African Americans (AAs). However, the prevalence or determinants of PH in the AA population is not known.
  
  
  METHODS
  We conducted a cross-sectional study to estimate the prevalence of PH (defined as trans-tricuspid gradient ≥ 35 mm Hg) and associated clinical characteristics in AAs using the Jackson Heart Study cohort (n=3,282) who underwent echocardiography and had a measurable trans-tricuspid regurgitant jet. Echocardiography is frequently used for screening for PH despite its limitations in estimating accurate PA systolic pressures. Overall and age-adjusted gender-specific prevalence were estimated and modified Poisson regression was used to identify independent clinical, spirometric, and echocardiographic characteristics associated with PH.
  
  
  RESULTS
  The mean age of the study population was 56.1 ± 12.6 years with 67.5% female. The prevalence of PH was 6.8%, with higher prevalence in female AAs (age-adjusted prevalence: Men 4.9%, 95% CI 3.6-6.2%; Women 7.7%, 95% CI 6.6-8.8%). Pulmonary hypertension prevalence increased with age (Prevalence Ratio: 10.0, 95%CI 4.0-25.1, >65 versus <45 years old), presence of obesity, higher pulse pressure, diabetes, obstructive or restrictive spirometry pattern, and severe left heart valvular disease. Also, PH was significantly associated with left atrial size and left ventricular ejection fraction.
  
  
  CONCLUSIONS
  Pulmonary hypertension is prevalent in AAs, more in women than in men. The identified cardiopulmonary risk factors that increase the prevalence of PH may assist in diagnosis and management of these at-risk subjects in the AA population.
authors.affiliation: Vascular Research Laboratory, Providence VA Medical Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America ; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Choudhary
authors.affiliation: Vascular Research Laboratory, Providence VA Medical Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America ; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
authors.forename: Matthew
authors.initials: M
authors.lastname: Jankowich
authors.affiliation: Vascular Research Laboratory, Providence VA Medical Center, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America ; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America.
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Wu
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors