Q&A: Risk of pulmonary arterial hypertension increases with age

Dr. Gregory Roth, Director of the Program for Cardiovascular Health Metric at IHME, shares the latest findings on pulmonary arterial hypertension (PAH) from the Global Burden of Disease study. 

This transcript has been lightly edited for clarity

What is pulmonary arterial hypertension, or PAH? What can you tell me about its impact on a person's health?

Pulmonary arterial hypertension, or PAH, is a progressive disease in which the blood vessels that carry blood from the heart to the lungs progressively narrow over time. And it’s really a devastating condition. Individuals with this disease are quite ill, and the disease can progress rapidly to death. People, when they suffer from PAH, experience shortness of breath, an inability to exert themselves and get the things done that they need, and can be quite sick and even end up in the hospital.

What are the key findings from your recently-published research into PAH?

In this work, we really wanted to establish what the global burden of pulmonary arterial hypertension, or PAH, is around the world, in every country, for all of these diverse populations. And that’s quite a challenging thing to do.

We sought all of the available data that really told us how much PAH there is in the general population. And then we used a range of statistical methods to estimate that there are almost 200,000 individuals in the world today who are suffering from PAH.

Who is most affected by PAH, in terms of gender, age, and geography?

Our study showed that PAH is a disease that increases with age. And in fact, the age group that had the most PAH was in the mid to late 70s. Sometimes PAH is thought of as a condition that affects mostly younger people, but we found evidence that this may not, in fact, be quite right. In addition, we found evidence that while PAH affects both men and women, it does, at the global level, affect women more.

One of the goals of our study was to try and produce an estimate of PAH for every country in the world, and we did find variation in how much PAH there is depending on where you are in the world. We found higher levels of PAH in Western and Central Europe.

And we also found that PAH was lower in places like the United States. Now, it depends very much on what population you look at. And within any country or within any region, there’s quite a bit of variability. But on average, that’s the pattern that we found.

Why is your research important and what needs to be done about PAH?

It’s really important to establish roughly how much PAH we would expect there to be in a country, because health systems are really struggling with how to make use of limited resources. And one thing that’s true about PAH is that while there’s been significant progress in developing medications to treat it, those medications tend to be quite expensive, and the use of them requires very sophisticated diagnostic and therapeutic technologies, in particular for health systems that are rapidly expanding or developing in large countries that are still working on building out their hospital and clinic systems.

They need to figure out where PAH stands among all of the other diseases that are competing for resources and require investments. And we believe that our analysis really provides a new global benchmark for how much PAH we might anticipate or expect to find in a country.

And then there’s going to be variation. Some countries may be treating or diagnosing a lot more PAH than we’ve estimated, or they may be finding a lot less. And that helps them think about how to tailor their investments in pulmonary disease in general, and PAH in particular.