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ABSTRACT: Rationale
Lower socioeconomic status (SES) confers a heightened risk of common cardiovascular and pulmonary diseases and increased mortality. The association of SES with outcomes in patients with pulmonary arterial hypertension (PAH) is less clear.Objectives
To determine the association between SES and outcomes in patients with PAH.Methods
We performed a prospective cohort study at a national referral center for patients with PAH in China. Two hundred sixty-two consecutive incident patients aged 18 to 65 years with a diagnosis of idiopathic PAH were recruited between January 2007 and June 2011 and followed up until November 2011. The primary endpoint was all-cause mortality. An SES score for each patient was derived from their educational level, annual household income, occupation, and medical reimbursement rate.Measurements and main results
Patients with a lower SES had higher unadjusted mortality rates, with 3-year survival estimates of 50.1, 70.8, and 86.0% in increasing tertiles of SES (P for trend < 0.001). After adjustment for clinical features, hemodynamics, and type of PAH treatment, the hazard ratios for death were 2.98 (95% confidence interval, 1.51-5.89) in the lowest tertile of SES and 1.80 (95% confidence interval, 0.89-3.63) in the middle tertile of SES compared with the upper tertile (P for trend = 0.006).Conclusions
A lower SES is strongly associated with a higher risk of death in idiopathic PAH. This association was independent of clinical characteristics, hemodynamics, and treatment. Addressing the health disparities associated with a lower SES may improve the outcomes of patients with PAH.
SUBMITTER: Wu WH
PROVIDER: S-EPMC3603556 | biostudies-literature | 2013 Feb
REPOSITORIES: biostudies-literature
Wu Wen-Hui WH Yang Lu L Peng Fu-Hua FH Yao Jing J Zou Li-Ling LL Liu Dong D Jiang Xin X Li Jue J Gao Lan L Qu Jie-Ming JM Kawut Steven M SM Jing Zhi-Cheng ZC
American journal of respiratory and critical care medicine 20121206 3
<h4>Rationale</h4>Lower socioeconomic status (SES) confers a heightened risk of common cardiovascular and pulmonary diseases and increased mortality. The association of SES with outcomes in patients with pulmonary arterial hypertension (PAH) is less clear.<h4>Objectives</h4>To determine the association between SES and outcomes in patients with PAH.<h4>Methods</h4>We performed a prospective cohort study at a national referral center for patients with PAH in China. Two hundred sixty-two consecutiv ...[more]