Study objectives: To determine whether primary
pulmonary hypertension mortality in the United States increased since
1979 coincident with the introduction of anorexigens.
Design: Examination of annual age-adjusted and age-specific
primary pulmonary hypertension mortality in the United States from 1979
through 1996 and in five selected states from 1992 through 1996.
Setting: The United States, from 1979 through 1996.
Patients or participants: Residents of the United States,
from 1979 through 1996.
Measurements and results: Annual age-adjusted mortality
increased at different rates among white men and women and black men
and women. The greatest increase was among black women (who also had
the highest rates). Age-specific mortality showed a high rate among
infants < 1 year old, a low rate in childhood, and an ascending rate
throughout the remainder of life. Similar patterns were identified at
the state level.
Conclusions: Primary pulmonary
hypertension mortality in the United States has increased notably since
1979. Some portion of this increase may be related to the introduction
of anorexigens. Improvements in diagnostic recognition may also explain
part of the increase in mortality. These results need to be confirmed
in a diagnosis validation study, particularly because the same
mortality data suggest that the disease may be more common in the
elderly than has been previously reported.