Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry

Jeff Min; Rui Feng; David Badesch; Erika Berman-Rosenzweig; Charles Burger; Murali Chakinala; Teresa De Marco; Jeremy Feldman; Anna Hemnes; Evelyn M. Horn; Matthew Lammi; Stephen Mathai; John W. McConnell; Kenneth Presberg; Jeffrey Robinson; Jeffrey Sager; Oksana Shlobin; Marc Simon; Thenappan Thenappan; Corey Ventetuolo; Nadine Al-Naamani

doi:10.1513/AnnalsATS.202006-612OC

Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry

Jeff Min, Rui Feng, David Badesch, Erika Berman-Rosenzweig, Charles Burger, Murali Chakinala, Teresa De Marco, Jeremy Feldman, Anna Hemnes, Evelyn M. Horn, Matthew Lammi, Stephen Mathai, John W. McConnell, Kenneth Presberg, Jeffrey Robinson, Jeffrey Sager, Oksana Shlobin, Marc Simon, Thenappan Thenappan, Corey VentetuoloNadine Al-Naamani

Medicine - Cardiology Division

Research output: Contribution to journal › Article › peer-review

17 Scopus citations

Abstract

Rationale: 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. Objectives: To assess the effect of obesity on HRQoL, hospitalizations, and survival in patients with PAH. Methods: 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 and emPHasis-10. 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. Results: A total of 767 subjects were included (mean age of 57 years, 74% female, 33% overweight, and 40% with obesity), with median follow-up duration of 527 days. Overweight patients and patients with obesity had higher baseline emPHasis-10 scores (worse HRQoL), which persisted over time (P<0.001). Patients who are overweight and obese have a trend toward increased incidence of hospitalizations compared with normalweight patients (IRR, 1.34; 95% confidence interval [95% CI], 0.94- 1.92 and IRR, 1.33; 95% CI 0.93-1.89, respectively). Overweight patients and patients with obesity had lower risk of transplant or death compared with normal-weight patients (HR, 0.45; 95% CI, 0.25-0.80 and HR, 0.39; 95% CI, 0.22-0.70, respectively). Conclusions: In a large multicenter, prospective cohort of PAH, patients who were overweight or obese had worse disease-specific HRQoL despite better transplant-free survival compared with normal-weight patients. Future interventions should address the specific needs of these patients.

Original language	English (US)
Pages (from-to)	229-237
Number of pages	9
Journal	Annals of the American Thoracic Society
Volume	18
Issue number	2
DOIs	https://doi.org/10.1513/AnnalsATS.202006-612OC
State	Published - Feb 1 2021

Bibliographical note

Funding Information:
A complete list of additional PHAR Investigators may be found before the beginning of the REFERENCES. Supported by the U.S. National Institutes of Health K23 HL141584, Aldrighetti Research Award for Young Investigators. Author Contributions: N.A.-N. was responsible for the conception and design of the work. J.M., R.F., and N.A.-N. were responsible for the analysis of the data. J.M., R.F., D.B., E.B.-R., C.B., M.C., T.D.M., J.F., A.H., E.M.H., M.L., S.M., J.W.M., K.P., J.R., J.S., O.S., M.S., T.T., C.V., and N.A.-N. made contributions to the acquisition of and interpretation of the data and drafting and revising the manuscript for important intellectual content. All authors were responsible for ensuring the accuracy and integrity of the work and have given final approval for its publication.

Funding Information:
Acknowledgment: The Pulmonary Hypertension Association Registry (PHAR) is supported by Pulmonary Hypertension Care Centers, Inc., a supporting organization of the Pulmonary Hypertension Association. The authors thank the other investigators, the staff, and particularly the participants of the PHAR for their valuable contributions. A full list of participating PHAR sites and institutions can be found at www.PHAssociation.org/PHAR.

Publisher Copyright:
© 2021 by the American Thoracic Society.

Keywords

Hospitalization
Obesity
Pulmonary arterial hypertension
Quality of life
Survival analysis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access

10.1513/AnnalsATS.202006-612OC

OpenUrl availability

Full text

Cite this

Min, J., Feng, R., Badesch, D., Berman-Rosenzweig, E., Burger, C., Chakinala, M., De Marco, T., Feldman, J., Hemnes, A., Horn, E. M., Lammi, M., Mathai, S., McConnell, J. W., Presberg, K., Robinson, J., Sager, J., Shlobin, O., Simon, M., Thenappan, T., ... Al-Naamani, N. (2021). Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry. Annals of the American Thoracic Society, 18(2), 229-237. https://doi.org/10.1513/AnnalsATS.202006-612OC

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, O, Simon, M, Thenappan, T, Ventetuolo, C & Al-Naamani, N 2021, 'Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry', Annals of the American Thoracic Society, vol. 18, no. 2, pp. 229-237. https://doi.org/10.1513/AnnalsATS.202006-612OC

@article{7a348c30a3dd4753b909c9079a8ee8ac,

title = "Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry",

abstract = "Rationale: 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. Objectives: To assess the effect of obesity on HRQoL, hospitalizations, and survival in patients with PAH. Methods: 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 and emPHasis-10. 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. Results: A total of 767 subjects were included (mean age of 57 years, 74% female, 33% overweight, and 40% with obesity), with median follow-up duration of 527 days. Overweight patients and patients with obesity had higher baseline emPHasis-10 scores (worse HRQoL), which persisted over time (P<0.001). Patients who are overweight and obese have a trend toward increased incidence of hospitalizations compared with normalweight patients (IRR, 1.34; 95% confidence interval [95% CI], 0.94- 1.92 and IRR, 1.33; 95% CI 0.93-1.89, respectively). Overweight patients and patients with obesity had lower risk of transplant or death compared with normal-weight patients (HR, 0.45; 95% CI, 0.25-0.80 and HR, 0.39; 95% CI, 0.22-0.70, respectively). Conclusions: In a large multicenter, prospective cohort of PAH, patients who were overweight or obese had worse disease-specific HRQoL despite better transplant-free survival compared with normal-weight patients. Future interventions should address the specific needs of these patients.",

keywords = "Hospitalization, Obesity, Pulmonary arterial hypertension, Quality of life, Survival analysis",

author = "Jeff Min and Rui Feng and David Badesch and Erika Berman-Rosenzweig and Charles Burger and Murali Chakinala and {De Marco}, Teresa and Jeremy Feldman and Anna Hemnes and Horn, {Evelyn M.} and Matthew Lammi and Stephen Mathai and McConnell, {John W.} and Kenneth Presberg and Jeffrey Robinson and Jeffrey Sager and Oksana Shlobin and Marc Simon and Thenappan Thenappan and Corey Ventetuolo and Nadine Al-Naamani",

note = "Funding Information: A complete list of additional PHAR Investigators may be found before the beginning of the REFERENCES. Supported by the U.S. National Institutes of Health K23 HL141584, Aldrighetti Research Award for Young Investigators. Author Contributions: N.A.-N. was responsible for the conception and design of the work. J.M., R.F., and N.A.-N. were responsible for the analysis of the data. J.M., R.F., D.B., E.B.-R., C.B., M.C., T.D.M., J.F., A.H., E.M.H., M.L., S.M., J.W.M., K.P., J.R., J.S., O.S., M.S., T.T., C.V., and N.A.-N. made contributions to the acquisition of and interpretation of the data and drafting and revising the manuscript for important intellectual content. All authors were responsible for ensuring the accuracy and integrity of the work and have given final approval for its publication. Funding Information: Acknowledgment: The Pulmonary Hypertension Association Registry (PHAR) is supported by Pulmonary Hypertension Care Centers, Inc., a supporting organization of the Pulmonary Hypertension Association. The authors thank the other investigators, the staff, and particularly the participants of the PHAR for their valuable contributions. A full list of participating PHAR sites and institutions can be found at www.PHAssociation.org/PHAR. Publisher Copyright: {\textcopyright} 2021 by the American Thoracic Society.",

year = "2021",

month = feb,

day = "1",

doi = "10.1513/AnnalsATS.202006-612OC",

language = "English (US)",

volume = "18",

pages = "229--237",

journal = "Annals of the American Thoracic Society",

issn = "2329-6933",

publisher = "American Thoracic Society",

number = "2",

}

TY - JOUR

T1 - Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry

AU - Min, Jeff

AU - Feng, Rui

AU - Badesch, David

AU - Berman-Rosenzweig, Erika

AU - Burger, Charles

AU - Chakinala, Murali

AU - De Marco, Teresa

AU - Feldman, Jeremy

AU - Hemnes, Anna

AU - Horn, Evelyn M.

AU - Lammi, Matthew

AU - Mathai, Stephen

AU - McConnell, John W.

AU - Presberg, Kenneth

AU - Robinson, Jeffrey

AU - Sager, Jeffrey

AU - Shlobin, Oksana

AU - Simon, Marc

AU - Thenappan, Thenappan

AU - Ventetuolo, Corey

AU - Al-Naamani, Nadine

N1 - Funding Information: A complete list of additional PHAR Investigators may be found before the beginning of the REFERENCES. Supported by the U.S. National Institutes of Health K23 HL141584, Aldrighetti Research Award for Young Investigators. Author Contributions: N.A.-N. was responsible for the conception and design of the work. J.M., R.F., and N.A.-N. were responsible for the analysis of the data. J.M., R.F., D.B., E.B.-R., C.B., M.C., T.D.M., J.F., A.H., E.M.H., M.L., S.M., J.W.M., K.P., J.R., J.S., O.S., M.S., T.T., C.V., and N.A.-N. made contributions to the acquisition of and interpretation of the data and drafting and revising the manuscript for important intellectual content. All authors were responsible for ensuring the accuracy and integrity of the work and have given final approval for its publication. Funding Information: Acknowledgment: The Pulmonary Hypertension Association Registry (PHAR) is supported by Pulmonary Hypertension Care Centers, Inc., a supporting organization of the Pulmonary Hypertension Association. The authors thank the other investigators, the staff, and particularly the participants of the PHAR for their valuable contributions. A full list of participating PHAR sites and institutions can be found at www.PHAssociation.org/PHAR. Publisher Copyright: © 2021 by the American Thoracic Society.

PY - 2021/2/1

Y1 - 2021/2/1

N2 - Rationale: 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. Objectives: To assess the effect of obesity on HRQoL, hospitalizations, and survival in patients with PAH. Methods: 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 and emPHasis-10. 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. Results: A total of 767 subjects were included (mean age of 57 years, 74% female, 33% overweight, and 40% with obesity), with median follow-up duration of 527 days. Overweight patients and patients with obesity had higher baseline emPHasis-10 scores (worse HRQoL), which persisted over time (P<0.001). Patients who are overweight and obese have a trend toward increased incidence of hospitalizations compared with normalweight patients (IRR, 1.34; 95% confidence interval [95% CI], 0.94- 1.92 and IRR, 1.33; 95% CI 0.93-1.89, respectively). Overweight patients and patients with obesity had lower risk of transplant or death compared with normal-weight patients (HR, 0.45; 95% CI, 0.25-0.80 and HR, 0.39; 95% CI, 0.22-0.70, respectively). Conclusions: In a large multicenter, prospective cohort of PAH, patients who were overweight or obese had worse disease-specific HRQoL despite better transplant-free survival compared with normal-weight patients. Future interventions should address the specific needs of these patients.

AB - Rationale: 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. Objectives: To assess the effect of obesity on HRQoL, hospitalizations, and survival in patients with PAH. Methods: 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 and emPHasis-10. 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. Results: A total of 767 subjects were included (mean age of 57 years, 74% female, 33% overweight, and 40% with obesity), with median follow-up duration of 527 days. Overweight patients and patients with obesity had higher baseline emPHasis-10 scores (worse HRQoL), which persisted over time (P<0.001). Patients who are overweight and obese have a trend toward increased incidence of hospitalizations compared with normalweight patients (IRR, 1.34; 95% confidence interval [95% CI], 0.94- 1.92 and IRR, 1.33; 95% CI 0.93-1.89, respectively). Overweight patients and patients with obesity had lower risk of transplant or death compared with normal-weight patients (HR, 0.45; 95% CI, 0.25-0.80 and HR, 0.39; 95% CI, 0.22-0.70, respectively). Conclusions: In a large multicenter, prospective cohort of PAH, patients who were overweight or obese had worse disease-specific HRQoL despite better transplant-free survival compared with normal-weight patients. Future interventions should address the specific needs of these patients.

KW - Hospitalization

KW - Obesity

KW - Pulmonary arterial hypertension

KW - Quality of life

KW - Survival analysis

UR - http://www.scopus.com/inward/record.url?scp=85101173936&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85101173936&partnerID=8YFLogxK

U2 - 10.1513/AnnalsATS.202006-612OC

DO - 10.1513/AnnalsATS.202006-612OC

M3 - Article

C2 - 33085915

AN - SCOPUS:85101173936

SN - 2329-6933

VL - 18

SP - 229

EP - 237

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

IS - 2

ER -

Obesity in pulmonary arterial hypertension the pulmonary hypertension association registry

Abstract

Bibliographical note

Keywords

UN SDGs

Access

OpenUrl availability

Other files and links

Fingerprint

Cite this