Abstract 6206: Age-Associated Increases in Pulmonary Artery Systolic Pressure in the General Population
In contrast to systemic hypertension, less is known about pulmonary hypertension in the general community. Elevated pulmonary artery systolic pressure (PASP) is frequently seen in elderly persons at echo, yet the impact of aging on PASP is unclear. Previous studies in small, selected groups yielded mixed results, highlighting the need for population-based data. To assess:
Relationship between age and PASP
Association of PASP with increasing pulmonary capillary wedge pressure (PCWP) from age-related diastolic dysfunction, and increasing pulse pressure (PP) as an index of age-related vascular stiffening
Impact of PASP on survival Population-based study of random adults (N=1413; 63± 11y; 43% male) in Olmsted County, MN, followed for a median of 8.8 years from echo and spirometry at entry, till death or last contact.
PASP was derived from the tricuspid regurgitation velocity, PCWP from E/e′ and PP from brachial blood pressure. PASP (median 26; range 15–66 mmHg) increased with age (r=0.31; p<0.001) and correlated with PCWP and PP adjusting for age (p<0.001). In a subset without cardiopulmonary disease (N=430; EF>50%; FEV1>80%), PASP still increased with age (r=0.15; p=0.002) and PP (p=0.02), but not PCWP, after age-adjustment. Increasing PASP strongly predicted mortality independent of age and sex (Figure⇓). These data are the first population-based evidence of age-associated increases in PASP, related to both diastolic dysfunction and vascular stiffening with age, as well as its potent adverse prognostic impact. Future study is warranted to confirm its role as a novel cardiovascular risk factor and potential therapeutic target.