PAH found ‘common’ globally among women of childbearing age
More than 2 of every 100,000 females ages 15-49 affected, new study shows
Worldwide, pulmonary arterial hypertension (PAH) affects more than 2 of every 100,000 females ages 15 to 49 — women and girls of childbearing age — according to a new analysis of data spanning some three decades.
The researchers noted that the rates of PAH vary substantially in different parts of the world. So too does available treatment.
But overall, this analysis of data from 1990 through 2021 found that PAH is “a common condition among women of childbearing age (WCBA),” the scientists wrote.
“[This] systematic analysis of PAH burden among WCBA underscores the disease’s significant global impact and the necessity for continued research and tailored public health strategies,” the team wrote, additionally “calling for enhanced awareness, improved diagnostics, and more effective treatment modalities, particularly in resource-constrained settings.”
The findings may help inform policymakers’ decisions about resource allocation to alleviate the burden of PAH globally, the researchers noted.
Their study, “Global, Regional, and National Burden of Pulmonary Arterial Hypertension Among Women of Childbearing Age, 1990-2021: A Systematic Analysis for the Global Burden of Disease Study 2021,” was published in the journal Pulmonary Circulation.
PAH is a disorder marked by abnormally high pressure in the vessels that carry blood from the heart through the lungs, which puts abnormal strain on the heart.
The condition can be especially problematic during pregnancy, posing risks for both the pregnant person and the developing fetus. As such, special care considerations are needed when crafting policies to support PAH patients who may become pregnant or are interested in pregnancy.
Global data used to estimate PAH occurrence in females ages 15-49
In this study, two scientists in China combed through global data to estimate how common PAH is in women of childbearing age — dubbed WCBA. The scientists defined WCBA as females aged 15 to 49.
The results showed that, in 2021, the worldwide prevalence of PAH in WCBA was 2.35 of every 100,000 people. The incidence of PAH — that is, the number of newly diagnosed cases each year — was 0.43 of every 100,00 people. Meanwhile, the overall mortality rate from PAH in the individuals in this group was 0.09 of every 100,000 people.
Statistical analyses looking region by region showed that PAH was most common among WCBA in Western Europe, with a higher prevalence in Switzerland than in any other single country. This “could be attributed to advanced healthcare systems and diagnostic technologies, which allow for earlier and more accurate identification of PAH cases,” the team noted.
The lowest rates of PAH among WCBA were reported in South Asia.
The data indicate significant disparities in the prevalence and impact of PAH across nations, underscoring the imperative for policymakers in heavily affected nations to allocate resources [toward] comprehensive epidemiological investigations to comprehensively understand the burden of PAH among [women of childbearing age].
As for incidence, the country found to be highest was Zambia, which the investigators attributed to known endemic viral infections, parasitic diseases, and inherited blood disorders associated with PAH.
Overall, according to the scientists, “the data indicate significant disparities in the prevalence and impact of PAH across nations, underscoring the imperative for policymakers in heavily affected nations to allocate resources [toward] comprehensive epidemiological investigations to comprehensively understand the burden of PAH among WCBA.”
The team also noted that rates of PAH-related death have decreased over the three-decade span of the study. That likely reflects improvements in treatment, the scientists noted.
Models show expected increase in PAH cases among women of childbearing age
Using these data, the researchers also constructed statistical models to predict how rates of PAH among WCBA will change in the coming decades.
The scientists’ models suggested that the total number of WCBA with PAH, as well as rates of PAH-related death and disability, will decline gradually by 2050. However, the number of newly diagnosed WCBA with PAH is expected to increase slightly by 2050.
These prediction models “can inform policymakers’ strategic planning for targeted interventions and healthcare resource allocation, addressing the evolving demands posed by PAH and its associated comorbidities [coexisting conditions] in an increasingly complex healthcare landscape,” the scientists wrote.
As limitations to their analysis, the researchers noted that changes in diagnostic criteria and technologies have occurred over the study period, which may have impacted the data. They also noted that data quality and accessibility varied across countries and regions, which could lead to an underestimation of PAH in certain areas.
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