Agne Taraseviciute1, Norbert F Voelkel. 1. Pulmonary Hypertension Center, University of Colorado Health Science Center, Box C272, 4200 E. 9th Ave., Denver, Colorado 80262, USA.
Abstract
CONTEXT: Severe pulmonary hypertension (PH) is a rare disorder triggered by a variety of factors and disease conditions and characterized by a shared pathophysiology. Two decades ago it was widely held that "primary" (idiopathic) pulmonary hypertension (PPH) is a disease of young women. However, we noticed recently in the UCHSC Pulmonary Hypertension Center that women with severe PH are frequently postmenopausal and overweight or obese. OBJECTIVES: To determine whether severe PH is a disease not only of young women but also of postmenopausal women who are overweight or obese. DESIGN, SETTING, AND PARTICIPANTS: The medical records of 541 postmenopausal female patients at the UCHSC Pulmonary Hypertension Center were reviewed. The patients were divided into two groups based on their diagnosis of either primary or secondary PH. MAIN OUTCOME MEASURES: The medical records of postmenopausal women with severe PH were further reviewed for history of diabetes, systemic hypertension, and the use of anti-depressants, hormone replacement therapy, combination of anti-depressants and hormone replacement therapy, as well as anorexigens. Laboratory data such as elevated cholesterol, elevated uric acid, and elevated C-reactive protein (CRP) were recorded in these patients, as well as physical exam data to determine the body-mass index (BMI) of the patients. RESULTS: 56% of all pulmonary hypertensive women who were patients at the UCHSC Pulmonary Hypertension Center were postmenopausal. 39% of postmenopausal women with PPH and 48% with secondary severe PH were obese. In addition, postmenopausal obese women frequently had systemic hypertension and were on hormone replacement therapy as well as antidepressant medication. CONCLUSIONS: Obesity, hormone replacement therapy and anti-depressant therapy may contribute to the development of severe PH in genetically predisposed women. Further investigation, in the form of a prospective, case-control study, is needed to determine whether these factors exert a causative effect in postmenopausal women.
CONTEXT: Severe pulmonary hypertension (PH) is a rare disorder triggered by a variety of factors and disease conditions and characterized by a shared pathophysiology. Two decades ago it was widely held that "primary" (idiopathic) pulmonary hypertension (PPH) is a disease of young women. However, we noticed recently in the UCHSC Pulmonary Hypertension Center that women with severe PH are frequently postmenopausal and overweight or obese. OBJECTIVES: To determine whether severe PH is a disease not only of young women but also of postmenopausal women who are overweight or obese. DESIGN, SETTING, AND PARTICIPANTS: The medical records of 541 postmenopausal female patients at the UCHSC Pulmonary Hypertension Center were reviewed. The patients were divided into two groups based on their diagnosis of either primary or secondary PH. MAIN OUTCOME MEASURES: The medical records of postmenopausal women with severe PH were further reviewed for history of diabetes, systemic hypertension, and the use of anti-depressants, hormone replacement therapy, combination of anti-depressants and hormone replacement therapy, as well as anorexigens. Laboratory data such as elevated cholesterol, elevated uric acid, and elevated C-reactive protein (CRP) were recorded in these patients, as well as physical exam data to determine the body-mass index (BMI) of the patients. RESULTS: 56% of all pulmonary hypertensivewomen who were patients at the UCHSC Pulmonary Hypertension Center were postmenopausal. 39% of postmenopausal women with PPH and 48% with secondary severe PH were obese. In addition, postmenopausal obesewomen frequently had systemic hypertension and were on hormone replacement therapy as well as antidepressant medication. CONCLUSIONS: Obesity, hormone replacement therapy and anti-depressant therapy may contribute to the development of severe PH in genetically predisposed women. Further investigation, in the form of a prospective, case-control study, is needed to determine whether these factors exert a causative effect in postmenopausal women.
Authors: Meiqian Weng; Michael J Raher; Patricio Leyton; Terry P Combs; Philipp E Scherer; Kenneth D Bloch; Benjamin D Medoff Journal: Am J Respir Cell Mol Biol Date: 2010-11-12 Impact factor: 6.914
Authors: Charles D Burger; Aimee J Foreman; Dave P Miller; Robert E Safford; Michael D McGoon; David B Badesch Journal: Mayo Clin Proc Date: 2011-02 Impact factor: 7.616
Authors: R T Zamanian; G Hansmann; S Snook; D Lilienfeld; K M Rappaport; G M Reaven; M Rabinovitch; R L Doyle Journal: Eur Respir J Date: 2008-12-01 Impact factor: 16.671
Authors: Soban Umar; Andrea Iorga; Humann Matori; Rangarajan D Nadadur; Jingyuan Li; Federica Maltese; Arnoud van der Laarse; Mansoureh Eghbali Journal: Am J Respir Crit Care Med Date: 2011-06-23 Impact factor: 21.405
Authors: Eric E Kelley; Jeff Baust; Gustavo Bonacci; Franca Golin-Bisello; Jason E Devlin; Claudette M St Croix; Simon C Watkins; Sonia Gor; Nadiezhda Cantu-Medellin; Eric R Weidert; Jefferson C Frisbee; Mark T Gladwin; Hunter C Champion; Bruce A Freeman; Nicholas K H Khoo Journal: Cardiovasc Res Date: 2014-01-02 Impact factor: 10.787
Authors: M Weng; D M Baron; K D Bloch; A D Luster; J J Lee; B D Medoff Journal: Am J Physiol Lung Cell Mol Physiol Date: 2011-09-09 Impact factor: 5.464
Authors: Ahmed Abdallah Salman; Mohamed Abdalla Salman; Hossam El-Din Shaaban; Ahmed Abdelsalam; Mohamed Tourky; Samah M Lotfy; Haitham S E Omar; Mohamed Saber Mostafa; Mohammed A Nafea; Ahmed Abd El Aal Sultan; Mohammed Hassan Elshafey; Abdoh Salem; Walid Rafat Abdelaty; Osama Osman Khaliel; Hani Maurice Sabri Mikhail Journal: Obes Surg Date: 2020-07-16 Impact factor: 4.129