Study of the Week: Is Metabolic Syndrome a Risk Factor for Pulmonary Arterial Hypertension?

Welcome to Study of the Week from Patient Worthy. In this segment, we select a study we posted about from the previous week that we think is of particular interest or importance and go more in-depth. In this story we will talk about the details of the study and explain why it’s important, who will be impacted, and more.

If you read our short form research stories and find yourself wanting to learn more, you’ve come to the right place.


This week’s study is…

Association between metabolic syndrome and pulmonary arterial hypertension

We previously published about this research in a story titled “Is There a Link Between PAH and Metabolic Syndrome?” which can be found here. The study was originally presented as a poster for the 2022 National Lipid Association’s Scientific Sessions, which were held on June 2-5.

What Happened?

Metabolic syndrome is a grouping of at least three of the following five medical conditions: low high-density lipoprotein (HDL), abdominal obesity, high serum triglycerides, high blood pressure, and high blood sugar. This syndrome is well known for triggering an elevated risk of diabetes and heart disease. In this study, the researchers sought to determine if metabolic syndrome could increase the risk of pulmonary arterial hypertension (PAH), a condition of elevated blood pressure in the lung arteries.

This study entailed a retrospective analysis of data from the two year period of 2016-2018. This data was derived from the Nationwide Impatient Sample, with individual patients selected using the appropriate ICD-10 diagnostic code. The data sample ultimately included 150,095 patients with metabolic syndrome. Compared to the remaining patients that did not have the syndrome, they were more likely to have obesity (64 vs 16 percent), hypertension (46.1 vs 34.4 percent), and diabetes (58.5 vs 26.4 percent). 

The scientists adjusted for age, comorbidity burden, and sex, and found that metabolic syndrome was linked to an increased risk for pulmonary arterial hypertension. In addition, in people with pulmonary arterial hypertension, metabolic syndrome was linked to a greater chance of major cardiac events, such as heart attack. However, the researchers found that the syndrome did not impact length of stay, in-hospital mortality, or other complications, such as acute heart failure, acute respiratory failure, or acute coronary syndrome.

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.

Why Does it Matter?

The results of this retrospective study appear to reveal a new risk factor for pulmonary arterial hypertension. As the cause of the disease is not particularly well understood, these revelations give scientists and physicians a better grasp on who could be at risk for developing it.

“Further studies are needed to explicate the association of metabolic syndrome and PAH as well as to develop potentially effective therapies,” concluded the study authors.

In addition, the data also has more immediate implications for the management of patients with metabolic syndrome and pulmonary arterial hypertension since it found that these patients were at a greater risk of a major adverse cardiac event. Clearly, physicians who are entrusted in caring for these patients must account for this in treatment and disease management whenever possible.

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