Pulmonary hypertension risk factors: Difference between revisions

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* BMPR2 gene mutation
* BMPR2 gene mutation
* ALK1 gene mutation
* ALK1 gene mutation
* [[Drug]]s and [[toxin]]s
* [[Connective tissue disease]]
* [[Connective tissue disease]]
* [[HIV]] infection
* [[HIV]] infection
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* [[Schistosomiasis]]
* [[Schistosomiasis]]
* Chronic [[hemolytic anemia]]
* Chronic [[hemolytic anemia]]
* [[Drug]]s and [[toxin]]s
Shown below is a table summarizing the list of drugs associated with PAH.
{|
| Definite risk || Possible risk || Likely risk || Unlikely risk
|-
| * [[Aminorex]] <br>
* [[Fenfluramine] <br>
* [[Dexfenfluramine]] <br>
* Toxic rapeseed oil <br>
* [[Benfluorex]]
|* [[Cocaine]] <br>
* [[Pjenylpropanolamine]]<br>
* [[St John's wort]] <br>
* [[Chemotherapy]] <br>
* [[Selective serotonin reuptake inhibitor]]s <br>
* [[Pergolide]]
|* [[Amphetamine]] <br>
* [[L-tryptophan]] <br>
* [[Metamphetamine]]
|* [[Oral contraception]]
* [[Estrogen therapy]]
* [[Smoking]]
|}


===Pulmonary hypertension due to Left Heart Disease===
===Pulmonary hypertension due to Left Heart Disease===
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* Fibrosing [[mediastinitis]]
* Fibrosing [[mediastinitis]]
* [[Chronic renal failure]] on [[dialysis]]
* [[Chronic renal failure]] on [[dialysis]]
===Gender===
Females are at least two-and-a-half more likely to have idiopathic and familial pulmonary hypertension than males.
===Family History===
A positive family history is defined by having two or more family members with a gene mutation causing pulmonary hypertension.
===Co-morbidities===
Certain diseases or conditions, such as heart and [[lung diseases]], [[liver disease]], [[HIV]] infection, [[connective tissue disorders]] like [[scleroderma]] and [[lupus]] are associated with pulmonary hypertension.
===Obstructive Sleep Apnea===
Obstructive sleep apnea predisposes to pulmonary hypertension by causing a drop in oxygen level when the patient is asleep.
===Predisposition to Recurrent Pulmonary Embolism===
===Drugs and Toxins use===
The use of street drugs (such as [[cocaine]]) or certain appetite suppressors like methamphetamines and the diet drug “fen phen” predisposes to having pulmonary hypertension.
===Chronic Hypoxemia===
Living at high altitudes for a long period of time is a risk factor.
===Pregnancy===
*While [[pregnancy]] in itself is not considered a risk factor for pulmonary hypertension, a female who gets pregnant and has pulmonary hypertension carries a higher risk of mortality, for this reason, pregnancy is contraindicated in patients with PAH.
*If needed, birth control pills containing the lowest amount of estrogen are recommended. However, nearly half of the specialists did not advocate using birth control pills for their patients, and some actively discouraged patients from doing so because of concern over the possible role of estrogen in worsening PAH.<ref>Consensus statement issued by the scientific leadership council,  birth control and hormonal therapy in pulmonary arterial hypertension.</ref>
===Thalassemia===
Pulmonary hypertension is present in 2.1% of patients with [[thalassemia]], for whom advanced age and splenectomy are risk factors.<ref name="pmid24081970">{{cite journal| author=Derchi G, Galanello R, Bina P, Cappellini MD, Piga A, Lai ME et al.| title=Prevalence and Risk Factors for Pulmonary Arterial Hypertension in a Large Group of β-Thalassemia Patients Using Right Heart Catheterization: A Webthal Study. | journal=Circulation | year= 2014 | volume= 129 | issue= 3 | pages= 338-45 | pmid=24081970 | doi=10.1161/CIRCULATIONAHA.113.002124 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24081970  }} </ref>


==References==
==References==

Revision as of 20:07, 28 August 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Ralph Matar

Overview

BMPR2 mutation, systemic sclerosis, HIV infection, portal hypertension, fenfluramine use, congenital heart disease with shunt, recent acute pulmonary embolism, and sickle cell disease are established risk factors for development of pulmonary arterial hypertension. On the other hand, patients in a hypercoagulable state (such as the presence of lupus anticoagulant, deficiency of protein C, protein S, or antithrombin III, chronic inflammatory disorders, myeloproliferative syndromes, and splenectomy) are at an increased risk for chronic thromboembolic pulmonary hypertension.[1]

Risk Factors

Pulmonary Arterial Hypertension

Shown below is a table summarizing the list of drugs associated with PAH.

Definite risk Possible risk Likely risk Unlikely risk
* Aminorex
* Cocaine
* Amphetamine
* Oral contraception

Pulmonary hypertension due to Left Heart Disease

  • Systolic dysfunction
  • Diastolic dysfunction
  • Left valvular disease

Pulmonary Hypertension due to Lung Diseases and/or Hypoxia

Chronic Thromboembolic Pulmonary Hypertension

PH with Unclear and/or Multifactorial Mechanisms

References

  1. ↑ McLaughlin, VV.; Archer, SL.; Badesch, DB.; Barst, RJ.; Farber, HW.; Lindner, JR.; Mathier, MA.; McGoon, MD.; Park, MH. (2009). "ACCF/AHA 2009 expert consensus document on pulmonary hypertension: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association: developed in collaboration with the American College of Chest Physicians, American Thoracic Society, Inc., and the Pulmonary Hypertension Association". Circulation. 119 (16): 2250–94. doi:10.1161/CIRCULATIONAHA.109.192230. PMID 19332472. Unknown parameter |month= ignored (help)

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