Patients with pulmonary hypertension age ≥65 years have worse long-term survival compared with younger patients, a difference likely reflective of a longer diagnosis delay and higher comorbidity burden in older patients, according to study results published in ERJ Open Research.

A total of 248 consecutive patients with pulmonary hypertension from a French regional referral center for pulmonary hypertension were included in the study. Patients enrolled in the study had precapillary pulmonary hypertension and were categorized as young (<65 years; n=101), elderly (65-74 years; n=82), and very elderly (≥75 years; n=65). Researchers compared groups for overall survival and sought to identify prognostic factors for mortality.

Elderly and very elderly patients had a longer time to diagnosis of pulmonary hypertension compared with younger patients (9±21 months and 16±32 months vs 7±48 months, respectively; P =.001). Compared with young and elderly patients, very elderly patients had a higher prevalence of comorbidities, including systemic arterial hypertension (P <.001), coronary artery disease (P =.05), and cardiac arrhythmias (P <.001).

Although overall survival was 46±1.4 months, elderly patients and very elderly patients had an overall survival of 37±4.9 months and 28±4.7 months, respectively. Factors associated with mortality in the univariate analysis included male sex, etiologic group 3 pulmonary hypertension, a 6-minute walking distance of <210 meters, and a history of chronic obstructive pulmonary dysfunction, stroke, or cognitive disorders.


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Study limitations included its retrospective design, the use of patient data taken from a single center, and the heterogeneous patient population.

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According to the researchers, the difference between elderly and very elderly patients and younger patients with regard to long-term survival “is likely to be related to a longer delay in diagnosis and a higher burden of comorbidities.”

Reference

Ginoux M, Turquier S, Chebib N, et al. Impact of comorbidities and delay in diagnosis in elderly patients with pulmonary hypertension. ERJ Open Res. 2018;4(4).