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Poor Quality of Life for Patients with Pulmonary Hypertension

Results of a new study identify specific clinical characteristics linked to poor quality of life in patients with PAH.

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Abilio Reis, MD, and fellow researchers in Portugal have found that patients with pulmonary arterial hypertension (PAH) and other forms of pre-capillary pulmonary hypertension (pcPH) report poor quality of life (QoL) which is highly associated with World Health Organization (WHO) functional class, 6 minute walking distance, and Borg dyspnea indices.

Click through the slides for highlights of their study and a few clinical take home points at the end.

Source: Reis A, Santos M, Vicente M, et al. Health-related quality of life in pulmonary hypertension and its clinical correlates: a cross-section study. Biomed Res Int. 2018 Mar 19;2018:3924517. doi: 10.1155/2018/3924517. eCollection 2018.
 

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PAH and Quality of Life. PAH has a significant impact on patient functionality, QoL, and health related (HR) QoL
Data are limited on the relationship between PAH disease severity/clinical characteristics and HRQoL impairment.
Authors sought to characterize HRQoL in patients with PAH and to explore clinical correlates.

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The Study. Cross-sectional, observational study looking at consecutive patients with PAH and other forms of precapillary PH; mean diseae duration was <50 mos. One general and one disease-specific quality of life questionnaire was completed by each participant.
 

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The Results. Most patients were WHO functional class (FC) I or II (69.4%). Both CAMPHOR and NHP scores were indicative of moderate HRQoL impairment. The most common PH etiologies were chronic thromboembolic pulmonary hypertension (24.5%), congenital heart disease (22.4%), idiopathic/heritable (22.4%), connective tissue disease (14.3%), and others (16.3%). Others included PAH-associated portal hypertension (3 patients), HIV (1 patient), and group 5 PH (4 patients).

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Take Home Points

  • Moderately impaired HRQoL is common among patients with WHO FC I and II PAH. 
  • Greater disease severity correlates with greater levels of impairment.
  • HRQoL is impaired even in patients with PAH and low disease activity with associated low mortality.
  • Screen PAH patients for pain, low energy, sleep disturbances, social isolation, and impaired mobility and offer treatment as needed.
  • 6-minute walking distance and Borg dyspnea indices are good tests for determining PAH severity and QoL impairment.
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