John Granton, MD, Assistant Professor of Medicine, University of Toronto; Pulmonary Arterial Hypertension Programme, University Health Network, Toronto, ON.
Moiz Zafar, MD, Resident, Respiratory Medicine, McMaster University, Hamilton, ON; Pulmonary Arterial Hypertension Programme, University Health Network, Toronto, ON.
On first glance, a review of pulmonary arterial hypertension (PAH) in a journal that focuses on the health of the elderly may seem out of place. PAH is typically envisioned as a progressively disabling disease in young females. However, PAH is not a disease restricted to the young. Indeed, 20% of the patients followed in our pulmonary hypertension clinic are over the age of 65. Although information regarding the natural course of PAH has been described in a report of the National Registry for Primary Pulmonary Hypertension, this information is not representative of the elderly population.1 In particular, given the greater prevalence of comorbid conditions in the elderly, one must be particularly vigilant in searching for an underlying secondary cause of PAH. Owing to a paucity of information in this population, most of our comments derive from our own observations of PAH in the elderly and from inferences made from their younger counterparts.
PAH is defined as an elevation in pulmonary arterial pressure greater than 25mmHg at rest or 30mmHg with exercise.