Abstract 14460: Distribution and Determinants of Pulmonary Artery Systolic Pressure in African-Americans: The Jackson Heart Study
Introduction: Data from a Caucasian cohort established predictors of echocardiographically-determined pulmonary artery systolic pressure (PASP), but did not investigate the potential contributions of inflammation, endogenous pulmonary vasoconstrictors, or obstructive sleep apnea (OSA). We sought to (1) explore the distribution and determinants of PASP in an African-American cohort; and (2) evaluate the impact on PASP of CRP, endothelin levels, and risk for OSA.
Methods: The cohort consisted of 2168 African-American participants in the Jackson Heart Study (JHS) without known cardiovascular disease (57.0±11.9 years; 68.4% women). Clinical variables, biomarkers, and echocardiograms were collected during the JHS baseline exam. PASP was estimated from the tricuspid-regurgitation velocity. Risk for OSA was determined using a validated algorithm. Regression analyses were used to assess determinants of PASP.
Results: The median PASP was 27.0 mmHg and increased with age (r = 0.36; p<0.001). In univariate analyses, CRP (0.15, p<0.001), endothelin (0.11, p<0.001), and OSA risk correlated (0.11, p<0.001) modestly with PASP. In multivariate regression analysis, male sex, age, body mass index, pulse pressure, CRP, endothelin, mitral regurgitation, left ventricular ejection fraction (inverse), and percentage of predicted forced expiratory volume in 1 second (inverse) were independently associated with increasing PASP. OSA risk nearly achieved statistical significance in the multivariate model (p = 0.07).
Conclusion: Inflammation, endogenous pulmonary vasoconstrictors, and lung function contribute to determining PASP in African-Americans; OSA likely plays a role as well. The median value of PASP is similar to that observed in a community-based Caucasian cohort, as is the observed increase in PASP with age. Future research will evaluate the impact of PASP on cardiovascular outcomes and mortality in the JHS cohort.
- © 2011 by American Heart Association, Inc.