Mortality from primary pulmonary hypertension in the United States, 1979-1996.

Abstract

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.