Why Do More Females Get Pulmonary Hypertension?


Though the commonly accepted ratio is 3:1 women, longtime clinicians suggest PAH ratio is more likely closer to 4:1.

The majority of pulmonary hypertension (PH) patients are female. The reason why that is cannot be fully explained, except for that it carries some genetic implication.

Bearing that in mind, clinicians are tasked with keeping an active eye for pulmonary hypertension or arterial hypertension (PAH) symptoms in women, and providing proper care. How that might formulate, Gary Palmer, MD, MBA, Vice President of Medical Affairs for Actelion Pharmaceuticals and Victor Tapson, MD, Director of the Venous Thromboembolism & Pulmonary Vascular Disease Research Program at the Cedars-Sinai Medical Center, told MD Magazine®, is in additional care providers and more frequent check-ups.

Palmer and Tapson discussed the gender disaprities in patients with PH and PAH while attending the 2018 CHEST Annual Meeting in San Antonio, TX, this week.

MD Mag: What is the gender disparity in prevalence and treatment of pulmonary arterial hypertension?Palmer: So, pulmonary hypertension a very interesting condition. It's actually more common in women than it is in men, for reasons that we don't really understand. but it’s maybe 65% women, 35% men, from a range of different causes. I guess that there are differences in the way people seek care.

And actually, in this disease, it’s very important to have a caregiver, as well. I think as people progress, they need help. We need more and more help to cope with things, and we find that women are more likely to seek help than men are just in general, but maybe I cannot start to test them on the way, because it's a fascinating difference.

Tapson: I mean, Gary already alluded to the fact that PAH is more common in women, and when they look at pulmonary arterial hypertension, the disease we actually are trying to treat here is idiopathic pulmonary hypertension scleroderma. That's even more common in women. It's probably, statistically, 3-to-1. It's probably even closer, to my perspective, to 4-to-1 women-to-men. For PAH, like Gary said, about 65/35. It is something genetic. But it's important now. A lot of women we see, or younger women—they may be in their 20s, 30s, or 40s—may have families with little kids. It’s incredibly challenging. And many of them are working, too.

I think trying to be specific and address these issues is really important—as Gary mentioned, to have a supportive pulmonary hypertension caregiver. There's often an important PAH nurse, or nurse practitioner involved as well. We tend to call people in between visits to check in and see how they're doing on their on their dosing or their medications, for example.

So gender difference is important, and just the degree of support patients need is important.

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