TY - JOUR T1 - The obesity paradox in pulmonary arterial hypertension: the Scottish perspective JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00241-2019 VL - 5 IS - 4 SP - 00241-2019 AU - Luke Lawson McLean AU - Katherine Pellino AU - Melanie Brewis AU - Andrew Peacock AU - Martin Johnson AU - Alistair Colin Church Y1 - 2019/10/01 UR - http://openres.ersjournals.com/content/5/4/00241-2019.abstract N2 - Pulmonary arterial hypertension (PAH) is a rare disease characterised by progressive pulmonary vascular remodelling, resulting in right ventricular failure, which is the principal cause of death [1]. Excessive bodyweight is a well-established independent risk factor for the development of cardiovascular disease and mortality [2]. However, data have emerged for a variety of chronic cardiovascular diseases, particularly heart failure, showing lower long-term mortality in obese patients [3]. This has been termed the “obesity paradox”. It challenges clinical reasoning and the significant healthcare expenditure directed toward weight loss in the general population.Analysis of pulmonary arterial hypertension patients in Scotland across 20 years supports a recent French study suggesting there is no protective effect from obesity for this disease, in contrast to emerging evidence from the USA and China http://bit.ly/34WCZ7W ER -