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Article

Prevalence, Incidence and Associates of Pulmonary Hypertension Complicating Type 2 Diabetes: Insights from the Fremantle Diabetes Study Phase 2 and National Echocardiographic Database of Australia

1
School of Medicine, The University of Notre Dame, Fremantle, WA 6160, Australia
2
The Heart Research Institute, Newtown, NSW 2042, Australia
3
Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
4
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
5
Fremantle Hospital, Medical School, The University of Western Australia, Fremantle, WA 6160, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Juan F. Delgado Jiménez
J. Clin. Med. 2021, 10(19), 4503; https://doi.org/10.3390/jcm10194503
Received: 31 August 2021 / Revised: 25 September 2021 / Accepted: 27 September 2021 / Published: 29 September 2021
(This article belongs to the Section Endocrinology & Metabolism)
There is a paucity of epidemiologic data examining the relationship between pulmonary hypertension (PH) and diabetes. The aim of this study was to determine prevalence, incidence and associates of PH complicating type 2 diabetes. Data from 1430 participants (mean age 65.5 years, 51.5% males) in the Fremantle Diabetes Study Phase 2 (FDS2) were linked with the National Echocardiographic Database of Australia (NEDA) to ascertain the prevalence and incidence of PH (estimated right ventricular systolic pressure (eRVSP) >30 mmHg as a new suggested threshold or the conventional >40 mmHg) over a 12-year period. PH prevalence in FDS2 was compared with that in NEDA overall and a geographically close sub-population. Multivariable analyses identified associates of prevalent/incident PH in the FDS2 cohort. Of 275 FDS2 patients (19.2%) with pre-entry echocardiography, 90 had eRVSP >30 mmHg and 35 had eRVSP >40 mmHg (prevalences 32.7% (95% CI 27.3–38.7%) and 12.7% (9.1–17.4%), respectively), rates that are 35–50% greater than national/local NEDA general population estimates. Moreover, 70 (5.0%) and 123 (9.2%) FDS2 participants were identified with incident PH at the respective eRVSP thresholds (incidence (95% CI) 7.6 (6.0–9.7) and 14.2 (11.8–17.0)/1000 person-years), paralleling data from recognised high-risk conditions such as systemic sclerosis. The baseline plasma N-terminal pro-brain natriuretic peptide concentration was the strongest independent associate of prevalent/incident PH. Approximately 1 in 8 people with type 2 diabetes have PH using the eRVSP >40 mmHg threshold. Its presence should be considered as part of regular clinical assessment of individuals with type 2 diabetes. View Full-Text
Keywords: type 2 diabetes; pulmonary hypertension; prevalence; incidence; risk factors type 2 diabetes; pulmonary hypertension; prevalence; incidence; risk factors
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MDPI and ACS Style

Nundlall, N.; Playford, D.; Strange, G.; Davis, T.M.E.; Davis, W.A. Prevalence, Incidence and Associates of Pulmonary Hypertension Complicating Type 2 Diabetes: Insights from the Fremantle Diabetes Study Phase 2 and National Echocardiographic Database of Australia. J. Clin. Med. 2021, 10, 4503. https://doi.org/10.3390/jcm10194503

AMA Style

Nundlall N, Playford D, Strange G, Davis TME, Davis WA. Prevalence, Incidence and Associates of Pulmonary Hypertension Complicating Type 2 Diabetes: Insights from the Fremantle Diabetes Study Phase 2 and National Echocardiographic Database of Australia. Journal of Clinical Medicine. 2021; 10(19):4503. https://doi.org/10.3390/jcm10194503

Chicago/Turabian Style

Nundlall, Nishant, David Playford, Geoff Strange, Timothy M. E. Davis, and Wendy A. Davis. 2021. "Prevalence, Incidence and Associates of Pulmonary Hypertension Complicating Type 2 Diabetes: Insights from the Fremantle Diabetes Study Phase 2 and National Echocardiographic Database of Australia" Journal of Clinical Medicine 10, no. 19: 4503. https://doi.org/10.3390/jcm10194503

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