Pulmonary vascular disease & thromboembolism
Systemic Hypertension and Survival in Pulmonary Hypertension
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.74 95% CI 0.68–0.79Authors' conclusion
In this global PH cohort, higher sSAP was associated with enhanced survival, while a higher baseline heart rate and declining systemic blood pressure during follow-up were significantly associated with increased mortality risk.
Study context
- Population
- Patients with incident pulmonary hypertension (PH groups 1–5, all age categories) diagnosed via right heart catheterization, from the Pulmonary Vascular Research Institute GoDeep meta-registry, diagnosis decades 1980 to 2020patients with incident PH, median [IQR] age, 65 [53–73] years, 7372 [58%] female · Europe 3,238 · North America 3,014 · Africa 96 · Asia 802 · Oceania 851
- Participants
- 12,771 patients
- Exposure
- Patients with hypertension compared to their counterparts without hypertension
- Outcome
- All-cause mortality
Methodological detailsmeta-registry integrating global retrospective and prospective PH cohorts, multivariable Cox proportional hazards models, sensitivity analyses, independent external validation in a UK cohort
- Meta-registry integrating global retrospective and prospective PH cohorts
- Multivariable Cox proportional hazards models
- Sensitivity analyses
- Independent external validation in a UK cohort
Main finding
As reported in the abstract
Hazard ratio
0.74
95% CI 0.68–0.79
Patients with hypertension vs Patients without hypertension
HR 0.74 (95% CI 0.68–0.79)
Observational data: associations, not effects.
Further findings
Survival by baseline systolic systemic arterial pressure (sSAP)
- Higher baseline sSAP independently associated with improved survival; survival benefits correlated positively with increasing sSAP (80-180 mm Hg)
- Consistent across PH groups and age groups; independent of antihypertensive and PH-specific medications
Mortality by heart rate
- Elevated heart rate associated with higher mortality
Cardiac index and TAPSE by sSAP
- sSAP increments correlated with improved cardiac index and tricuspid annular plane systolic excursion
Mortality by longitudinal sSAP and heart rate trajectories · during follow-up
- Decreased sSAP and higher heart rate during follow-up correlated with higher mortality
External validation
- External validation in a separate UK cohort confirmed these findings
Original publication
Systemic Hypertension and Survival in Pulmonary Hypertension. JAMA Cardiol. Published 30 October 2026. doi:10.
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