Increase in pulmonary pressure ups risk of dyspnoea

Pulmonary artery systolic pressure (PASP) has intensified over 6.5 years in late life, reports a study. Increases in PASP also correlate with increases in left ventricular (LV) filling pressure and with the development of dyspnoea.

A total of 1,420 participants in the Atherosclerosis Risk in Communities (ARIC) study with echocardiographic measures of PASP at the fifth (2011‒2013) and seventh (2018‒2019) visits were included in the current analysis. The authors quantified longitudinal changes in PASP over 6.5 years.

Furthermore, the extent to which cardiac and pulmonary dysfunction correlated with changes in PASP was determined and the association of these changes with dyspnoea development was defined using multivariable regression.

Participants had a mean age of 75 years at visit 5 and 81 years at visit 7. Of these, 24 percent were Black adults and 68 percent were women.

PASP rose by 5 mm Hg, from 28 to 33 mm Hg, over 6.5 years. Such an increase was greater among older ARIC participants. Worse LV systolic and diastolic function, pulmonary function, and renal function were associated with higher increases in PASP.

Additionally, increases in PASP showed an association with concomitant increases in measures of LV filling pressure, including E/e’ ratio and left atrial volume index. Each increase of 5 mm Hg resulted in a 16-percent greater chance of developing dyspnoea (odds ratio, 1.16, 95 percent confidence interval, 1.07‒1.27; p<0.001).

“Interventions targeting LV diastolic function may be effective at mitigating age-related increases in PASP,” the authors said.