Borderline Pulmonary Hypertension Patients Often Progress To Overt Disease Interview with:

Dr. Evan L. Brittain, MD Assistant Professor of Medicine Vanderbilt University School of Medicine

Dr. Brittain

Dr. Evan L. Brittain, MD
Assistant Professor of Medicine
Vanderbilt University School of Medicine What is the background for this study? What are the main findings?

Response: The purpose of this study was to determine whether pulmonary pressure values below the diagnostic threshold for pulmonary hypertension (25mmHg) are associated with an increased risk of mortality. We studied over 4,000 consecutive individuals referred for right heart catheterization, the “gold-standard” procedure for measuring pulmonary pressure. We found that borderline levels of mean pulmonary pressure (19-24mmHg) were common, representing 18% of all patients referred for this procedure. Borderline mean pulmonary pressure values were also associated with 31% increase in mortality after accounting for many other clinical factors. Finally, we found that most of the patients with borderline pulmonary hypertension who underwent repeat catheterization often progressed to overt pulmonary hypertension.

This study suggests that patients with borderline pulmonary hypertension should be considered an at-risk group. What should readers take away from your report?

Response: The take home message for patients and their providers is that these values should not be ignored just because they are below the diagnostic threshold for pulmonary hypertension. Borderline values of mean pulmonary pressure are meaningful and identify a group of patients at high risk of clinical events. What recommendations do you have for future research as a result of this study?

Response: Further studies are needed to determine whether more aggressive management of risk factors for pulmonary hypertension (e.g. high blood pressure, diabetes, obesity) lowers the risk of death in patients with borderline pulmonary hypertension. Thank you for your contribution to the community.


Assad TR, Maron BA, Robbins IM, Xu M, Huang S, Harrell FE, Farber-Eger EH, Wells QS, Choudhary G, Hemnes AR, Brittain EL. Prognostic Effect and Longitudinal Hemodynamic Assessment of Borderline Pulmonary Hypertension. JAMA Cardiol. Published online October 25, 2017. doi:10.1001/jamacardio.2017.3882

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on October 27, 2017 by Marie Benz MD FAAD