期刊
PLOS ONE
卷 12, 期 11, 页码 -出版社
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0187734
关键词
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资金
- (NIH) Institutional Development Award (IDeA) from National Institute of General Medical Sciences [P20GM103652]
- American Heart Association [11FTF7400032]
- Department of Veterans Affairs [1101BX002042-01A2]
- Catherine and Lowe Berger and Pauline L. Ford Chair at Indiana University
- National Institutes of Health [1R01HL128661, 1K08HL11207-01A1]
- American Heart Association (AHA) [15GRNT25080016]
- Pulmonary Hypertension Association
- Cardiovascular Medical Research and Education Fund (CMREF)
- Klarman Foundation at Brigham
Women have an increased risk of pulmonary hypertension (PH) but better survival compared to men. Few studies have explored sex-based differences in population-based cohorts with PH. We sought to determine whether sex was associated with hemodynamics and survival in US veterans with PH (mean pulmonary artery pressure [mPAP] >= 25 mm Hg) from the Veterans Affairs Clinical Assessment, Reporting, and Tracking database. The relationship between sex and hemodynamics was assessed with multivariable linear mixed modeling. Cox proportional hazards models were used to compare survival by sex for those with PH and precapillary PH (mPAP >= 25 mm Hg, pulmonary artery wedge pressure [PAWP] <= 15 mm Hg and pulmonary vascular resistance [PVR] > 3 Wood units) respectively. The study population included 15,464 veterans with PH, 516 (3%) of whom were women; 1,942 patients (13%) had precapillary PH, of whom 120 (6%) were women. Among those with PH, women had higher PVR and pulmonary artery pulse pressure, and lower right atrial pressure and PAWP (all p < 0.001) compared with men. There were no significant differences in hemodynamics according to sex in veterans with precapillary PH. Women with PH had 18% greater survival compared to men with PH (adjusted HR 0.82, 95% CI 0.69-0.97, p = 0.020). Similarly, women with precapillary PH were 29% more likely to survive as compared to men with PH (adjusted HR 0.71, 95% CI 0.52-0.98, p = 0.040). In conclusion, female veterans with PH have better survival than males despite higher pulmonary afterload.
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