Health Predictors in Patients With Secondary Pulmonary Hypertension, OSA

The prevalence of secondary pulmonary hypertension in patients with obstructive sleep apnea (OSA) is greater in women and patients who are Black. Men and patients who are White with OSA have higher rates of subsequent inpatient mortality after hospitalization with secondary pulmonary hypertension, according to results of a cohort study presented at the American Heart Association (AHA) 2022 Scientific Sessions 2022, held from November 5 through November 7, in Chicago, Illinois.

Study authors examined the predictors of hospitalization with secondary pulmonary hypertension and subsequent inpatient mortality in patients with obstructive sleep apnea (OSA). The National Inpatient Sample from 2019 and ICD-10 codes were used to identify patients hospitalized with OSA and secondary pulmonary hypertension. The study authors compared the odds and predictors of in-hospital mortality in individuals with OSA with and without secondary pulmonary hypertension.

Among a total of 2,317,136 adult hospitalized with OSA, 9.4% had secondary pulmonary hypertension. The median patient age was 66 years (range, 56-74 years); 57.2% of the patients were men.

Results of the study showed women with OSA had a higher prevalence of secondary pulmonary hypertension vs men with OSA (11.3% vs 8.1%) and patients who are Black had a higher prevalence compared with other racial groups.

Individuals with OSA hospitalized with secondary pulmonary hypertension were more likely to be women (51% vs 41.9%, respectively), Black (20.9% vs 14.0%, respectively), from the lowest income quartiles (29.7% vs 27.6%, respectively), insured by Medicare (73.4% vs 60.6%, respectively), and hospitalized unplanned (89.2% vs 74.4%, respectively) compared with individuals hospitalized with OSA without secondary pulmonary hypertension.

Additionally, individuals with OSA hospitalized with secondary pulmonary hypertension had a higher burden of complicated hypertension (52.9% vs 36.3%, respectively), diabetes with complications (42.7% vs 32.4%, respectively), hyperlipidemia (59.4% vs 57.6%, respectively), chronic obstructive pulmonary disease (52.5% vs 36.9%, respectively), history of myocardial infarction (11.4% vs 9.6%, respectively), and venous thromboembolism (10.4% vs 8.4%, respectively) compared with individuals hospitalized with OSA without secondary pulmonary hypertension.

In-hospital mortality was more likely to be reported in men than women (odds ratio [OR], 1.12; 95% CI, 1.00-1.25; P =.048) and in patients with OSA and concomitant metastatic cancer (OR, 2.73; 95% CI, 2.04-3.65) or solid nonmetastatic tumors (OR, 1.65; 95% CI, 1.26-2.15; P <.001).

Further, the present analysis also demonstrated that Black ethnicity, hyperlipidemia, obesity, tobacco use, and history of venous thromboembolism and transient ischemic attack were protective against inpatient mortality in patients with OSA and secondary pulmonary hypertension.

According to the authors, “More prospective studies are needed to understand the role of co-morbidities on survival outcomes.”

This article originally appeared on The Cardiology Advisor.