Delayed Disease Recognition in One in Five Patients With PAH

Patients under 36 have highest odds of delayed diagnosis of pulmonary arterial hypertension

FRIDAY, July 8 (HealthDay News) -- One in five patients report symptoms of pulmonary arterial hypertension (PAH) for more than two years before the disease is diagnosed, with patients younger than 36 years being most likely to experience delayed recognition, according to a study published in the July issue of Chest.

Lynette M. Brown, M.D., Ph.D., from the Intermountain Medical Center in Murray, Utah, and colleagues assessed the factors associated with delayed recognition of PAH. A total of 2,967 adult patients with PAH were enrolled in the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) from March 2006 to September 2007. Delayed disease recognition was determined if there was a gap of more than two years between symptom onset and the patient receiving a PAH diagnosis, starting PAH-specific therapy, or receiving a diagnosis via right-sided heart catheterization.

The investigators found that 21.1 percent of patients experienced symptoms for more than two years before PAH was recognized. The highest likelihood of delayed disease recognition was seen in patients whose PAH symptoms began before the age of 36 years (odds ratio [OR], 3.07). A history of obstructive airways disease and sleep apnea (OR, 1.93 and 1.72, respectively) had an independent correlation with delayed PAH recognition. Correlations were also seen for a six-minute walk distance <250 m, right atrial pressure <10 mm Hg, and pulmonary vascular resistance <10 Wood units (OR, 1.91, 1.77, and 1.28, respectively).

"One in five patients in the REVEAL Registry who were diagnosed with PAH reported symptoms for >2 years before their disease was recognized," the authors write.

Several authors disclosed financial ties to the health care and pharmaceutical industries, including Actelion Pharmaceuticals U.S. Inc., which sponsored the study.

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