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Sex-specific differences and survival in patients with idiopathic pulmonary arterial hypertension 2008-2016

Kjellström, Barbro LU ; Nisell, Magnus ; Kylhammar, David LU ; Bartfay, Sven-Erik ; Ivarsson, Bodil LU ; Rådegran, Göran LU and Hjalmarsson, Clara (2019) In ERJ Open Research 5(3).
Abstract

Background: Women with idiopathic pulmonary arterial hypertension (IPAH) have been found to have a worse haemodynamic status at diagnosis, but better survival than men. Over the past decade, demographics have changed and new treatments have become available. The objective of this study was to investigate sex differences in an incident IPAH population diagnosed between 2008 and 2016.

Methods: Differences in clinical characteristics of patients included in the Swedish Pulmonary Arterial Hypertension Register (SPAHR) were analysed at the time of diagnosis. Survival by sex was investigated using Cox proportional hazard regression and Kaplan-Meier curves.

Results: The study included 271 patients diagnosed with IPAH, median age... (More)

Background: Women with idiopathic pulmonary arterial hypertension (IPAH) have been found to have a worse haemodynamic status at diagnosis, but better survival than men. Over the past decade, demographics have changed and new treatments have become available. The objective of this study was to investigate sex differences in an incident IPAH population diagnosed between 2008 and 2016.

Methods: Differences in clinical characteristics of patients included in the Swedish Pulmonary Arterial Hypertension Register (SPAHR) were analysed at the time of diagnosis. Survival by sex was investigated using Cox proportional hazard regression and Kaplan-Meier curves.

Results: The study included 271 patients diagnosed with IPAH, median age was 68 (1st-3rd quartiles 54-74) years and 56% were women. At diagnosis, women were younger, had lower pulmonary vascular resistance and fewer comorbidities and more often received a combination of PAH-targeted therapies than men. Men had worse survival rates than women (hazard ratio 1.49; CI 1.02-2.18; p=0.038), but this difference did not remain after adjustment for age (hazard ratio 1.30; CI 0.89-1.90; p=0.178).

Conclusions: Men with incident IPAH have worse crude survival than women. This is due to women being younger with a less pronounced comorbidity burden than men at the time of diagnosis.

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author
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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
ERJ Open Research
volume
5
issue
3
publisher
European Respiratory Society
external identifiers
  • pmid:31423450
  • scopus:85106230684
ISSN
2312-0541
DOI
10.1183/23120541.00075-2019
language
English
LU publication?
yes
id
c2b36d50-fcc6-4a78-9de2-8fbdb730c255
date added to LUP
2020-07-07 16:16:39
date last changed
2024-06-15 00:08:54
@article{c2b36d50-fcc6-4a78-9de2-8fbdb730c255,
  abstract     = {{<p>Background: Women with idiopathic pulmonary arterial hypertension (IPAH) have been found to have a worse haemodynamic status at diagnosis, but better survival than men. Over the past decade, demographics have changed and new treatments have become available. The objective of this study was to investigate sex differences in an incident IPAH population diagnosed between 2008 and 2016.</p><p>Methods: Differences in clinical characteristics of patients included in the Swedish Pulmonary Arterial Hypertension Register (SPAHR) were analysed at the time of diagnosis. Survival by sex was investigated using Cox proportional hazard regression and Kaplan-Meier curves.</p><p>Results: The study included 271 patients diagnosed with IPAH, median age was 68 (1st-3rd quartiles 54-74) years and 56% were women. At diagnosis, women were younger, had lower pulmonary vascular resistance and fewer comorbidities and more often received a combination of PAH-targeted therapies than men. Men had worse survival rates than women (hazard ratio 1.49; CI 1.02-2.18; p=0.038), but this difference did not remain after adjustment for age (hazard ratio 1.30; CI 0.89-1.90; p=0.178).</p><p>Conclusions: Men with incident IPAH have worse crude survival than women. This is due to women being younger with a less pronounced comorbidity burden than men at the time of diagnosis.</p>}},
  author       = {{Kjellström, Barbro and Nisell, Magnus and Kylhammar, David and Bartfay, Sven-Erik and Ivarsson, Bodil and Rådegran, Göran and Hjalmarsson, Clara}},
  issn         = {{2312-0541}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{European Respiratory Society}},
  series       = {{ERJ Open Research}},
  title        = {{Sex-specific differences and survival in patients with idiopathic pulmonary arterial hypertension 2008-2016}},
  url          = {{http://dx.doi.org/10.1183/23120541.00075-2019}},
  doi          = {{10.1183/23120541.00075-2019}},
  volume       = {{5}},
  year         = {{2019}},
}