The association of pulmonary hypertension with rheumatoid arthritis
Pulmonary arterial hypertension (PAH) is a recognized but rare complication of rheumatoid arthritis (RA). PAH is a type of high blood pressure that occurs in the right side of the heart and in the arteries that supply blood to the lungs. It occurs when the pulmonary arteries thicken or grow rigid. This makes blood flow more difficult. When this happens, the body can not get the oxygen it needs.
The pulmonary arteries contract, forcing the heart to work faster and harder to push blood through the arteries and the arteries are not able to carry adequate blood to the lungs, hence causing high blood pressure (hypertension). They may also experience shortness of breath, chest pain and dizziness.
Researchers sought to study the prevalence of pulmonary arterial hypertension in an unselected population with rheumatoid arthritis, irrespective of the presence of breathlessness at baseline, using stress echocardiography (SE) as a screening tool. This study was an observational prevalence study aimed to confirm the reported increased prevalence of PAH in people diagnosed with rheumatoid arthritis. PAH worsens over the time and is life-threatening because the pressure in patient’s pulmonary arteries rises to dangerously high levels, putting a strain on the heart.
This study demonstrated that there is a significant prevalence of EchoCG-defined Pulmonary hypertension (PH) in patients with rheumatoid arthritis, with 14% of RA patients showed elevation of resting systolic pulmonary artery pressure (PASP) > 35 mmHg. In the study, the prevalence of PAH was increased with the incorporation of SE, although clinical relevance and specificity of these findings require further study.
Scientists hope that their finding will pave the way for better understanding of the causes of PAH, so need to be evaluated in greater depth for the proper management strategies for these conditions.