Late-Life Increases in Pulmonary Pressure and Hypertension Predict Dyspnea Development

Основные понятия

Pulmonary artery systolic pressure increases in late life, predicting dyspnea development.

Аннотация

TOPLINE:

• PASP increases in late life, predicting dyspnea.

METHODOLOGY:

• Longitudinal PASP changes in adults aged 75.5 to 81.5 years.
• PASP estimated by Doppler echo.
• Multivariable regression analysis used to associate cardiac and pulmonary dysfunction with PASP changes.

TAKEAWAY:

• PASP increased by 5 ± 8 mmHg over 6 years.
• Prevalence of pulmonary hypertension increased from 3% to 25%.
• Each 5-mmHg increase in PASP associated with 16% higher odds of dyspnea.
• LV, pulmonary, and renal dysfunction associated with greater PASP increases.

IN PRACTICE:

• Primary prevention in mid- and late-life may mitigate worsening pulmonary pressure.

SOURCE:

• Study published in the Journal of the American College of Cardiology.

LIMITATIONS:

• Echocardiographic PASP measurement may introduce misclassification.
• Limited follow-up information after age 81.5 years.

Статистика

PASP increased by 5 ± 8 mmHg over 6 years.
Prevalence of pulmonary hypertension increased from 3% to 25%.
Each 5-mmHg increase in PASP associated with 16% higher odds of developing dyspnea.

Цитаты

"Primary prevention of end-organ damage in mid- and late-life may help mitigate worsening pulmonary pressure in late-life," - Authors

Ключевые выводы из

Late-Life Increases in Pulmonary Pressure, Hypertension

by Megan Brooks в www.medscape.com 11-30-2023

https://www.medscape.com/viewarticle/998935

Дополнительные вопросы

How can early intervention strategies impact late-life pulmonary pressure?

Early intervention strategies can have a significant impact on late-life pulmonary pressure by focusing on primary prevention of end-organ damage. By identifying and controlling risk factors such as cardiac, pulmonary, and renal dysfunction in mid- and late-life, it is possible to mitigate the worsening of pulmonary pressure in late life. This proactive approach can help in preventing the development of conditions like pulmonary hypertension and dyspnea, which are associated with increased pulmonary pressure. By addressing these risk factors early on, individuals may experience better cardiovascular outcomes and reduced progression of pulmonary pressure abnormalities as they age.

What are the implications of the study's limitations on its findings?

The study's limitations, such as the use of echocardiographic determination of PASP instead of the gold standard right heart catheterization, and the lack of follow-up information after age 81.5 years, have implications on the interpretation and generalizability of the findings. The potential misclassification of PASP due to echocardiographic measurement may introduce inaccuracies in the results, affecting the reliability of the observed changes in pulmonary pressure over time. Additionally, the absence of follow-up data limits the ability to assess the prognostic value of changes in PASP in late life, hindering a comprehensive understanding of the long-term implications of increased pulmonary pressure on cardiovascular outcomes. These limitations highlight the need for further research with more robust methodologies to validate and expand upon the current findings.

How might advancements in echocardiographic technology improve PASP measurement accuracy in future studies?

Advancements in echocardiographic technology can enhance PASP measurement accuracy in future studies by improving the precision and reliability of the measurements. Innovations in imaging techniques, such as 3D echocardiography and strain imaging, can provide more detailed and comprehensive assessments of cardiac function, allowing for a more accurate estimation of PASP. Additionally, the development of automated algorithms and software tools can help standardize PASP calculations and reduce variability in measurements, leading to more consistent and reproducible results. By leveraging these technological advancements, researchers can enhance the accuracy and validity of echocardiographic PASP measurements, enabling a more precise evaluation of pulmonary pressure changes and their clinical implications in various populations.