Pulmonary hypertension risk factors
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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
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.[2]
Thalassemia
Pulmonary hypertension is present in 2.1% of patients with thalassemia, for whom advanced age and splenectomy are risk factors.[3]
References
- ↑ 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) - ↑ Consensus statement issued by the scientific leadership council, birth control and hormonal therapy in pulmonary arterial hypertension.
- ↑ Derchi G, Galanello R, Bina P, Cappellini MD, Piga A, Lai ME; et al. (2014). "Prevalence and Risk Factors for Pulmonary Arterial Hypertension in a Large Group of β-Thalassemia Patients Using Right Heart Catheterization: A Webthal Study". Circulation. 129 (3): 338–45. doi:10.1161/CIRCULATIONAHA.113.002124. PMID 24081970.