Chest
Volume 117, Issue 3, March 2000, Pages 796-800
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Special Reports
PULMONARY VASCULATURE
Mortality From Primary Pulmonary Hypertension in the United States, 1979–1996

https://doi.org/10.1378/chest.117.3.796Get rights and content

Study objectives

To determine whether primary pulmonary hypertension mortality in the United States increased since 1979 coincident with the introduction of anorexigens.

Design

Examination of annual age-adjusted and age-specific primary pulmonary hypertension mortality in the United States from 1979 through 1996 and in five selected states from 1992 through 1996.

Setting

The United States, from 1979 through 1996.

Patients or participants

Residents of the United States, from 1979 through 1996.

Interventions

None.

Measurements and results

Annual age-adjusted mortality increased at different rates among white men and women and black men and women. The greatest increase was among black women (who also had the highest rates). Age-specific mortality showed a high rate among infants < 1 year old, a low rate in childhood, and an ascending rate throughout the remainder of life. Similar patterns were identified at the state level.

Conclusions

Primary pulmonary hypertension mortality in the United States has increased notably since 1979. Some portion of this increase may be related to the introduction of anorexigens. Improvements in diagnostic recognition may also explain part of the increase in mortality. These results need to be confirmed in a diagnosis validation study, particularly because the same mortality data suggest that the disease may be more common in the elderly than has been previously reported.

Section snippets

Materials and Methods

In the United States, death certificates for all residents are coded, processed, and tabulated by the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC). These data are available through the CDC Wonder System on the World Wide Web (http://wonder.cdc.gov/). These data were reviewed for deaths in which primary pulmonary hypertension (International Classification of Diseases, Ninth Revision [ICD-9] rubric 416.0) was coded as the underlying cause. The

Results

The average annual age-adjusted primary pulmonary hypertension (ICD-9 rubric 416.0) death rates for white men, white women, black men, and black women are shown in Table 1. These rates are based on > 20,000 deaths. In general, the rates for blacks are the highest for both men and women. Among men, the age-adjusted rate for blacks is more than twice that of whites, and for women, three times.

The temporal trends in age-adjusted primary pulmonary hypertension in the United States from 1979 through

Discussion

We found that aged-adjusted mortality from primary pulmonary hypertension in the United States from 1979 through 1996 was more frequent among blacks than whites and more common among women than men. The greatest mortality rates are experienced among infants, although children in general experience the lowest death rates. After childhood, death rates increase with age. Our examination of mortality in five states disclosed that their mortality experiences followed closely that of the United

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Dr. Rubin holds an Academic Award in Vascular Diseases from the National Heart, Lung, and Blood Institute.

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