Pulmonary hypertension: prevalence and risk factors

AbstractIntroductionPulmonary arterial hypertension (PAH), defined as a systolic pulmonary artery pressure above 35mmHg, is another vascular disease entity recently described in patients receiving hemodialysis. It is a major problem due to its high prevalence and morbidity and mortality. Its pathophysiological mechanism is just known and the strategies for its supported not yet defined.AimsTo determine the prevalence of PAH in our hemodialysis patients and its risk factors.MethodologySingle center descriptive and analytical cross-sectional study, including 111 hemodialysis patients who had benefit from a trans-thoracic cardiac Doppler ultrasound during 2014. A value greater than or equal to 35mmHg is considered PAH and classified as follows: mild PAH (3550mmHg), moderate PAH (5070mmHg), and severe pulmonary hypertension (>70mmHg). Patients with a high probability of secondary PAH, especially those with the following history: chronic obstructive pulmonary disease, pulmonary embolism, were not included.ResultsThe mean age was 44.3±14.2years. Among the 111 patients, 18 had pulmonary arterial pressure above 35mmHg corresponding to 16.22% of PAH prevalence. The average pressure was 45mmHg. Of these 18 patients, 11.8% had mild PAH, 3.4% moderate PAH and 0.8% severe PAH. The average hemodialysis duration was significantly associated with PAH (p=0.003); as well as valvular calcification (p=0.000), mitral regurgitation (p=0.001) and tricuspid regurgitation (p=0.002).ConclusionPrimary pulmonary hypertension is a major problem among our hemodialysis because of its high prevalence and its risk factors