The Effects of Race on Pulmonary Arterial Hypertension Outcomes

According to a story from consultant360.com, a recent study was conducted in order to determine if racial ancestry had any impacts on outcomes in the rare disease pulmonary arterial hypertension (PAH). This is a subject that has almost never been investigated before. As the medical system in the Western world (and the US more specifically) tends to be racially biased towards people of white, European ancestry, we would expect this group to have better outcomes generally. However, this study found that people of Latinx or Native American ancestry actually had an inpatient mortality benefit compared to white patients.

About Pulmonary Arterial Hypertension (PAH)

Pulmonary arterial hypertension is a condition in which the blood pressure in the arteries of the lungs is abnormally high. The cause of pulmonary arterial hypertension is often unknown in many cases. However, there are a variety of potential causes, such as certain heritable genetic mutations, exposure to certain toxins, and drug use (ex. methamphetamine). It can also appear as a symptom or complication in a number of other diseases, such as heart disease, connective tissue disease, and infection with HIV. The arteries in the lungs are often inflamed. Symptoms of this condition include rapid heartbeat, poor exercise tolerance, shortness of breath, fainting, leg swelling, fatigue, and chest pain. Treatment may include a number of medications and surgical operations, including lung transplant. A transplant can cure the condition, but it can cause many complications. Survival rate is often only about two or three years without treatment, but the latest drugs can prolong life by several years or more. Click here to learn more about pulmonary arterial hypertension.

About the Study

The analysis was conducted using patient data from two local cohorts and two national disease registries. A meta-analysis of these datasets concluded that patients of Latinx racial ancestry had significantly reduced mortality when compared to patients of white, European descent. This resulted in a hazard ratio of 0.60. An investigation of the 2 national registry cohorts suggested that Native American descent also conferred a mortality benefit compared to whites; this hazard ratio was 0.48.

Another third cohort was analyzed for inpatient mortality odds ratios for different racial groups. This investigation reproduced in the benefit seen in the other cohorts, producing an inpatient mortality benefit for people of Native American and Latinx descent, with hazard ratios of 0.38 and 0.65. These hazard ratios were calculated for transplant-free, all cause mortality.

Overall the findings suggest that Native Americans and Latinx people have a meaningful survival benefit in pulmonary arterial hypertension when compared to whites.

Learn more about this study here.

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