PURPOSE: To assess mortality trends by race and gender for idiopathic pulmonary hypertension (PAH) in the United States.
METHODS: The United States National Center for Health Statistics data for the years 1994 to 1998 were reviewed for deaths in which the underlying cause was Idiopathic Pulmonary Hypertension. The age, gender, race, and state of residence of the deceased were abstracted from the Center for Disease Control Wonder System (wonder.cdc.gov). The state-age-gender-race-specific tabulations of deaths as a result of PAH were then aggregated into nine geographic regions of the United States as defined by the Census Bureau. Average annual age-adjusted region-race-gender-specific rates were calculated using the method of Lilienfeld and Stolley, with the 2000 United States population as the standard. The method of Chiang was used to estimate the standard error for each age-adjusted rate.
RESULTS: Black women demonstrated the highest mortality rates for PAH across all age groups compared to other racial and gender groups. No geographical differences in mortality rates were noted. A bimodal distribution of mortality rates was observed in all racial and gender groups, with higher mortality rates from PAH noted in infants and the elderly.
CONCLUSION: Racial disparities in pulmonary hypertension morbidity and mortality are now being recognized, with black women exhibiting substantially increased mortality compared with all other groups. The reasons for this disparity remain unclear. Socioeconomic factors, access to care, co-morbidities and potentially genetic factors specific to race may all impact on PAH outcomes and contribute to the increased mortality seen in black women.
CLINICAL IMPLICATIONS: This study gives a new perpective on race and gender as risk factors for increased mortality in Idiopathic Pulmonary Hypertension. Further studies are needed to determine why these differences exist.
DISCLOSURE: Kala Davis, None.