Idiopathic (or unexplained) pulmonary hypertension (IPAH) has been characterized as an illness that affects mostly young women. In the article by Shapiro et al1 from the Mayo Clinic in this issue of CHEST (see page 94), we now see IPAH as also affecting elderly men and women, with a seemingly worse prognosis. Is this a different illness or perhaps an overlooked subset of IPAH?
Actually, the description of IPAH in the elderly is not new. In the National Institutes of Health Registry on Primary Pulmonary Hypertension,2– which collected data from 1981 to 1986, 9% of the patients were > 60 years old. A recent report3 of a large registry of pulmonary hypertension (PH) in France reported that 9% of the patients were now > 70 years old. Thus, one can conclude that IPAH harbors no age discrimination. It affects people of all ages.