title: Response to pulmonary arterial hypertension drug therapies in patients with pulmonary arterial hypertension and cardiovascular risk factors.
abstract: The age at diagnosis of pulmonary arterial hypertension (PAH) and the prevalence of cardiovascular (CV) risk factors are increasing. We sought to determine whether the response to drug therapy was influenced by CV risk factors in PAH patients. We studied consecutive incident PAH patients (n = 146) between January 1, 2008, and July 15, 2011. Patients were divided into two groups: the PAH-No CV group included patients with no CV risk factors (obesity, systemic hypertension, type 2 diabetes mellitus, permanent atrial fibrillation, mitral and/or aortic valve disease, and coronary artery disease), and the PAH-CV group included patients with at least one. The response to PAH treatment was analyzed in all the patients who received PAH drug therapy. The PAH-No CV group included 43 patients, and the PAH-CV group included 69 patients. Patients in the PAH-No CV group were younger than those in the PAH-CV group (P < 0.0001). In the PAH-No CV group, 16 patients (37%) improved on treatment and 27 (63%) did not improve, compared with 11 (16%) and 58 (84%) in the PAH-CV group, respectively (P = 0.027 after adjustment for age). There was no difference in survival at 30 months (P = 0.218). In conclusion, in addition to older age, CV risk factors may predict a reduced response to PAH drug therapy in patients with PAH.
authors.affiliation: National Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Charalampopoulos
authors.affiliation: National Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom.
authors.forename: Luke S
authors.initials: LS
authors.lastname: Howard
authors.affiliation: Imperial College London, London, United Kingdom ; University of Ioannina, Ioannina, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Tzoulaki
authors.affiliation: National Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom.
authors.forename: Wendy
authors.initials: W
authors.lastname: Gin-Sing
authors.affiliation: Imperial College London, London, United Kingdom ; King's Lynn and Papworth Hospitals, Cambridge, United Kingdom ; Echocardiography Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Grapsa
authors.affiliation: Imperial College London, London, United Kingdom.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Wilkins
authors.affiliation: National Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom.
authors.forename: Rachel J
authors.initials: RJ
authors.lastname: Davies
authors.affiliation: Imperial College London, London, United Kingdom ; Echocardiography Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Petros
authors.initials: P
authors.lastname: Nihoyannopoulos
authors.affiliation: Cardiology Department, Imperial College Healthcare NHS Trust, London, United Kingdom ; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Connolly
authors.affiliation: National Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom ; National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: J Simon R
authors.initials: JS
authors.lastname: Gibbs
keywords: cardiovascular risk factors; pulmonary arterial hypertension; pulmonary arterial hypertension–targeted treatment