This paper presents an argument for taking a global view of the problem of pulmonary vascular disease. Since pulmonary hypertension may be a marker for advanced cardiac and pulmonary diseases, it emphasizes the need to educate health care leaders to begin establishing regional centers of excellence so that a worldwide approach can be applied that will benefit all.
This is one of the first studies to attempt to determine the prevalence of pulmonary hypertension in a community setting. The target population was patients diagnosed with HFpEF and followed over 3 years. They determined that pulmonary hypertension highly prevalent (83%), indicating the urgent need for a broader scale effort to screen for pulmonary hypertension. In addition, they show that pulmonary hypertension was strongly associated with mortality, underscoring the unmet need for therapies.
This is one of the more in-depth reviews of the global burden of pulmonary hypertension. They estimate a prevalence of 1% of the world population having pulmonary hypertension from any cause. They also estimate that the large majority of these patients (80%) live in developing countries, which emphasizes the challenge for both preventive and treatment strategies that will be affordable and accessible.
This screening study of more that 150,000 adults found a prevalence of pulmonary hypertension of greater than 18% ranging from mild to severe. In addition, they were able to show increasing mortality with the severity of pulmonary hypertension, beginning at the very lowest levels.
This large study of over 150,000 adults from the NEDA goes into deeper analysis to show how mild levels of elevation in pulmonary arterial pressure is associated with increased mortality in the general population. They conclude that notional screening strategies should be considered in as part of clinical surveillance programs.
This Canadian study includes a cohort of over 50,000 patients with pulmonary hypertension over a 10-year period. They confirm that the incidence and prevalence of pulmonary hypertension is increasing, with Group 2 and group 3 associated with the highest mortality.
This is a retrospective study of over 20,000 patients with pulmonary hypertension confirmed by cardiac catheterization, from any cause who were followed for clinical outcomes. Like other studies it confirmed the increasing mortality beginning at the mildest levels of increased pulmonary artery pressure. The case can be made for screening programs to detect early disease to initiate treatments.
This review from a leader in the global aspects of pulmonary hypertension describes how what has been considered a rare disease, pulmonary hypertension, is actually quite common when one looks beyond the Western Countries and considers low-middle income countries.
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