Abstract
Background Women with idiopathic pulmonary arterial hypertension (IPAH) have been found to have a worse haemodynamic status at diagnosis, but better survival than men. Over the past decade, demographics have changed and new treatments have become available. The objective of this study was to investigate sex differences in an incident IPAH population diagnosed between 2008 and 2016.
Methods Differences in clinical characteristics of patients included in the Swedish Pulmonary Arterial Hypertension Register (SPAHR) were analysed at the time of diagnosis. Survival by sex was investigated using Cox proportional hazard regression and Kaplan–Meier curves.
Results The study included 271 patients diagnosed with IPAH, median age was 68 (1st–3rd quartiles 54–74) years and 56% were women. At diagnosis, women were younger, had lower pulmonary vascular resistance and fewer comorbidities and more often received a combination of PAH-targeted therapies than men. Men had worse survival rates than women (hazard ratio 1.49; CI 1.02–2.18; p=0.038), but this difference did not remain after adjustment for age (hazard ratio 1.30; CI 0.89–1.90; p=0.178).
Conclusions Men with incident IPAH have worse crude survival than women. This is due to women being younger with a less pronounced comorbidity burden than men at the time of diagnosis.
Abstract
Despite minor differences in baseline characteristics between men and women, survival among patients with incident IPAH diagnosed 2008–2016 does not appear to be related to sex http://bit.ly/2JFgXhd
Footnotes
Conflict of interest: B. Kjellström has nothing to disclose.
Conflict of interest: M. Nisell has nothing to disclose.
Conflict of interest: D. Kylhammar has nothing to disclose.
Conflict of interest: S-E. Bartfay has nothing to disclose.
Conflict of interest: B. Ivarsson has nothing to disclose.
Conflict of interest: G. Rådegran has nothing to disclose.
Conflict of interest: C. Hjalmarsson has nothing to disclose.
Support statement: During the initiation of SPAHR, Actelion Pharmaceuticals Sweden AB, Bayer Health Care, Eli Lilly Sweden, Glaxo-SmithKline, NordicInfu Care and Pfizer gave financial support. Since 2011, SPAHR has qualified as a national quality register and the Swedish Association of Local Authorities and Regions give financial support. The financial supporters had no role in the data collection, analysis or interpretation and had no right in disapproving the manuscript.
- Received March 18, 2019.
- Accepted June 18, 2019.
- Copyright ©ERS 2019
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.