| Title | Obesity in Pulmonary Arterial Hypertension (PAH): The Pulmonary Hypertension Association Registry (PHAR). |
| Publication Type | Journal Article |
| Year of Publication | 2020 |
| Authors | Min, J, Feng, R, Badesch, D, Berman-Rosenzweig, E, Burger, C, Chakinala, M, De Marco, T, Feldman, J, Hemnes, A, Horn, EM, Lammi, M, Mathai, S, McConnell, JW, Presberg, K, Robinson, J, Sager, J, Shlobin, OA, Simon, M, Thenappan, T, Ventetuolo, C, Al-Naamani, N |
| Corporate/Institutional Authors | PHAR Investigators |
| Journal | Ann Am Thorac Soc |
| Date Published | 2020 Oct 21 |
| ISSN | 2325-6621 |
| Abstract | <p><b>RATIONALE: </b>Obesity is associated with pulmonary arterial hypertension (PAH), but its impact on outcomes such as health-related quality of life (HRQoL), hospitalizations and survival is not well understood.</p><p><b>OBJECTIVES: </b>To assess the effect of obesity on health-related quality of life (HRQoL), hospitalizations and survival in patients with PAH.</p><p><b>METHODS: </b>We performed a cohort study of adults with PAH from the Pulmonary Hypertension Association Registry, a prospective multicenter registry. Multivariate linear mixed effects regression was used to examine the relationship between weight categories and HRQoL using the Short Form-12 (SF-12) and emPHasis-10 (e10). We used multivariable negative binomial regression to estimate hospitalization incidence rate ratios (IRRs) and Cox regression to estimate hazard ratios (HRs) for transplant-free survival by weight status.</p><p><b>RESULTS: </b>767 subjects were included: mean age of 57 years, 74% female, 33% overweight and 40% obese, with median follow-up duration of 527 days. Overweight and obese patients had higher baseline e10 scores (worse HRQoL), which persisted over time (p<0.001). The overweight and obese have a trend towards increased incidence of hospitalizations compared to normal weight (IRR 1.34, 95% confidence interval (95%CI) 0.94-1.92 and 1.33, 95%CI 0.93-1.89, respectively). Overweight and obese patients had lower risk of transplant or death as compared to normal weight patients (HR 0.45, 95%CI 0.25-0.80 and 0.39, 95%CI 0.22-0.70, respectively).</p><p><b>CONCLUSIONS: </b>In a large multicenter, prospective cohort of PAH, overweight and obese patients had worse disease-specific HRQoL despite better transplant-free survival compared to normal weight patients. Future interventions should address the specific needs of these patients.</p> |
| DOI | 10.1513/AnnalsATS.202006-612OC |
| Alternate Journal | Ann Am Thorac Soc |
| PubMed ID | 33085915 |
