title: Prevalence of Pulmonary Hypertension in the General Population: The Rotterdam Study.
abstract: BACKGROUND
  Pulmonary hypertension is characterized by increased pulmonary artery pressure and carries an increased mortality. Population-based studies into pulmonary hypertension are scarce and little is known about its prevalence in the general population. We aimed to describe the distribution of echocardiographically-assessed pulmonary artery systolic pressure (ePASP) in the general population, to estimate the prevalence of pulmonary hypertension, and to identify associated factors.
  
  
  METHODS
  Participants (n = 3381, mean age 76.4 years, 59% women) from the Rotterdam Study, a population-based cohort, underwent echocardiography. Echocardiographic pulmonary hypertension was defined as ePASP>40 mmHg.
  
  
  RESULTS
  Mean ePASP was 26.3 mmHg (SD 7.0). Prevalence of echocardiographic pulmonary hypertension was 2.6% (95%CI: 2.0; 3.2). Prevalence was higher in older participants compared to younger ones (8.3% in those over 85 years versus 0.8% in those between 65 and 70), and in those with underlying disorders versus those without (5.9% in subjects with COPD versus 2.3%; 9.2% in those with left ventricular systolic dysfunction versus 2.3%; 23.1% in stages 3 or 4 left ventricular diastolic dysfunction versus 1.9% in normal or stage 1). Factors independently associated with higher ePASP were older age, higher BMI, left ventricular diastolic dysfunction, COPD and systemic hypertension.
  
  
  CONCLUSIONS
  In this large population-based study, we show that pulmonary hypertension as measured by echocardiography has a low prevalence in the overall general population in the Netherlands, but estimates may be higher in specific subgroups, especially in those with underlying diseases. Increased pulmonary arterial pressure is likely to gain importance in the near future due to population aging and the accompanying prevalences of underlying disorders.
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; School of Medicine, Pontifical Catholic University of Parana, Curitiba, Brazil.
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Moreira
authors.affiliation: Universities of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Giessen, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Gall
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Cardiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Maarten J G
authors.initials: MJ
authors.lastname: Leening
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Lies
authors.initials: L
authors.lastname: Lahousse
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Respiratory Medicine, Amphia Hospital, Breda, the Netherlands.
authors.forename: Daan W
authors.initials: DW
authors.lastname: Loth
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Bouwe P
authors.initials: BP
authors.lastname: Krijthe
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Kiefte-de Jong
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Respiratory Medicine, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Guy G
authors.initials: GG
authors.lastname: Brusselle
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands; Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands; Inspectorate for Health Care, The Hague, the Netherlands.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
authors.affiliation: Universities of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Giessen, Germany.
authors.forename: Hossein A
authors.initials: HA
authors.lastname: Ghofrani
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Janine F
authors.initials: JF
authors.lastname: Felix
mesh_terms: D000368:Aged; D004452:Echocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence