Characteristics of Japanese elderly patients with pulmonary arterial hypertension

Abstract

Background: Previous nationwide Japanese data suggested that pulmonary arterial hypertension (PAH) predominantly affects young women. However, the number of elderly patients diagnosed with PAH has been increasing in the western country. There have been no reports on elderly PAH patients from Asian countries. Aims and Objectives: This study aimed to investigate the clinical characteristics of elderly PAH patients in a Japanese cohort. Methods: Idiopathic/ heritable PAH (I/H-PAH) was included in the national research project on intractable diseases. The patients are required to submit a clinical research form completed by their attending physicians. We analyzed the characteristics of Japanese I/H-PAH using the registration forms in 2013 (study 1, n=153). Also, we did a retrospective, observational cohort study at Chiba University Hospital (study 2, n=42). We compared the characteristics of elderly PAH patients (≥65 years old) with younger patients ( Results: The analyses using the clinical forms revealed a predominance of males (53% male), better hemodynamics and poorer exercise capacity in the elderly group (n=59), compared with the younger group (n=62) in study 1. In study 2, elderly patients showed a male predominance (63% male), a higher ratio of smokers, a lower % carbon monoxide diffusing capacity, and poorer exercise tolerance. After the therapies in study 2, elderly patients showed less improvement in hemodynamics. There was no significant difference in disease-specific survival between them. Conclusion: Japanese elderly patients with I/H-PAH showed poorer exercise capacity and impaired gas exchange, but better pulmonary hemodynamics than younger patients.