New study links smoking to worse survival outcomes in men with PAH
Effect seen in PAH, but not in women with PAH or in CTEPH patients
Written by |
A history of smoking was associated with worse survival outcomes in male patients with pulmonary arterial hypertension (PAH), according to a new study.
The analysis found, however, that smoking history did not significantly affect survival in female PAH patients or in people with chronic thromboembolic pulmonary hypertension (CTEPH).
The study, “Smoking exposure on diagnosis and survival of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: Data from REHAP registry,” was published in Pulmonology.
Study examines smoking history and survival in PAH and CTEPH
Pulmonary hypertension refers to elevated pressure in the blood vessels that carry blood from the heart to the lungs. In PAH, these vessels become abnormally narrowed. In CTEPH, pressure becomes elevated due to blood clots.
Smoking cigarettes has many well-established negative health effects, but the impact of smoking history on outcomes in people with PAH or CTEPH has not been widely studied. To address this gap, scientists analyzed data from the Spanish Registry of Pulmonary Arterial Hypertension (REHAP), a program tracking long-term health outcomes in patients with PAH and CTEPH in Spain.
“Unfortunately, there are limited data about the effect of tobacco smoke exposure [on] PAH and CTEPH,” the researchers wrote. “Our study analyzes, for the first time, the impact of smoke exposure on diagnosis and survival in patients with PAH and CTEPH in Spain.”
The analysis included data from 1,293 people with PAH and 450 with CTEPH. In both groups, just over 40% of patients were ever-smokers, meaning they were either current or former smokers. About two-thirds of people with PAH and slightly more than half of those with CTEPH were female, though male patients were more likely to have a history of smoking in both groups.
Statistical analyses showed that survival outcomes for people with CTEPH were similar regardless of smoking history. For PAH, a sex-specific effect was seen: among male patients, a history of smoking was associated with significantly worse survival. However, survival outcomes were similar for female PAH patients regardless of smoking history.
Smoking history linked to worse survival in men with PAH
“Cigarette smoking is associated with delayed diagnosis and worse survival outcomes in PAH but not in CTEPH,” the researchers wrote. “Male ever-smokers … with PAH [have a] worse prognosis than female ever-smokers.”
The researchers noted that PAH patients with a history of smoking tended to be older at diagnosis than those without a smoking history. They suggested that differences in diagnosis timing may play a role in outcomes, although this was not directly established by the study.
“Diagnosis of PAH at an advanced stage is associated with poor survival, highlighting the importance of early disease recognition and treatment,” the researchers wrote.
The scientists called for further study aimed at understanding why smoking appears to have divergent effects in different types of pulmonary hypertension and between sexes in PAH.
