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. Author manuscript; available in PMC: 2023 Feb 3.
Published in final edited form as: J Am Coll Cardiol. 2022 Aug 16;80(7):697–718. doi: 10.1016/j.jacc.2022.05.038

Table 2.

Etiology of Disease: Risk Factors Reported

PH Overall (n = 750)
Comparator Overall (n = 347)
Group 1 Risk Factors Primary G1 (n = 353) G1 Risk Factors (n = 83) Primary G1 Comparator (n = 58) G1 Risk Factors (n = 72)

Idiopathic PAH 158 19 0 2
Connective tissue disease 93 54 41 31
 Systemic sclerosis 42 23 21 16
 Mixed connective tissue disease 16 7 5 3
 Rheumatoid arthritis 7 10 9 9
 Systemic lupus erythematosus 16 12 5 7
 Other connective tissue disease (Sjögren’s, antisynthetase syndrome, undifferentiated) 15 5 8 8
 Congenital heart disease 36 2 6 9
 Shunt repaired 15 1 3 6
Familial PAH 27 3 1 0
 HHT 4 2 0 0
HIV 10 4 0 2
Drug- and toxin-induced PAH 16 1 1 1
Portal hypertension 18 2 0 1
Mild PH (mPAP 21-<25 mm Hg) 0 0 10 27
ePAH (exercise mPAP ≤30 mm Hg, flow <10 L/min, and mPAP-Q slope >3) (mm Hg·min/L) 0 0 9 9
Connective tissue disease with mild (mPAP 21-<25 mm Hg) or no PH 0 0 43 27
Othera 10 0 0 0

Group 2 Risk Factors Primary G2 (n = 136) G2 Risk Factors (n = 105) Primary G2 Comparator (n = 140) G2 Risk Factors (n = 46)

Heart failure with preserved ejection fraction 100 83 76 28
Heart failure with reduced ejection fraction 26 13 19 2
Valvular heart disease 35 13 28 5
 Stenotic 19 4 13 2
 Regurgitant 29 12 19 3
Cardiomyopathy 14 2 28 2
 Hypertrophic 7 1 6 0
 Restrictive 6 0 2 0
Mild PVD risk associated with left heart disease (left heart disease with mPAP <25 mm Hg) 0 0 56 14
Moderate PVD risk associated with left heart disease 0 0 77 15
Isolated postcapillary pulmonary hypertension mPAP ≥25 mm Hg, PVR <3, DPG <7 (mm Hg) 0 0 56 8
 Provocable mPCW >18 with V waves <5 mm Hg after challenge, significant change from resting hemodynamics 0 0 23 9
 Provocable mPCW >15 with V waves >5 mm Hg after challenge, significant change from resting hemodynamics 0 0 45 6
Othera 3 2 3 0

Group 3 Risk Factors Primary G3 (n = 172) 3 Risk Factors (n = 218) Primary G3 Comparator (n = 119) G3 Risk Factors (n = 116)

Obstructive sleep apnea/obesity hypoventilation 58 127 43 82
COPD 66 56 35 16
 Mild to no PVD risk (mPAP <21 mm Hg) and COPD 0 0 7 3
 Moderate PVD risk (mPAP 21-<25 mm Hg) and COPD 0 0 12 2
Idiopathic pulmonary fibrosis 15 7 13 1
Other ILD (including CPFE, other ILD, SSc-ILD, hypersensitivity pneumonitis) 75 49 35 14
 Mild to no PVD risk (mPAP <21 mm Hg) and other ILD, including CPFE and SSc-ILD 0 0 12 3
 Moderate PVD risk (mPAP 21-<25 mm Hg) and other ILD, including CPFE and SSc-ILD 0 0 6 5
Nonparenchymal restrictive lung disease/thoracic cage abnormality 8 9 8 7
Cystic fibrosis 3 0 3 0
Othera 2 2 1 3

Group 4 Risk Factors Primary G4 (n = 57) G4 Risk Factors (n = 14) Primary G4 Comparator (n = 23) G4 Risk Factors (n = 10)

Chronic thromboembolic pulmonary hypertension 57 14 0 0
Pulmonary thromboendarterectomy 18 0 5 3
 Balloon pulmonary angioplasty 4 0 0 1
Chronic PE with mild to no PVD (mPAP <25 mm Hg) 0 0 21 6
Othera 0 0 2 1

Group 5 Risk Factors Primary G5 (n = 32) G5 Risk Factors (n = 9) Primary G5 Comparator (n = 7) G5 Risk Factors (n = 14)

Sarcoidosis 19 3 3 8
Myeloproliferative disease 3 3 1 5
Hemoglobinopathy 8 2 2 2
 Sickle cell 7 1 2 2
 Thalassemia 1 2 0 0
Othera 2 0 1 0

Values are n within group.

a

Other = schistosomiasis, pulmonary capillary hemangiomatosis, pulmonary veno-occlusive disease, or other conditions not otherwise listed.

CPFE = combined pulmonary fibrosis and emphysema; DPG = diastolic pressuregradient; G = group; ILD = interstitial lung disease; mPAP = mean pulmonary artery pressure; mPCW = mean pulmonary capillary wedge pressure; PAH = pulmonary arterial hypertension; PE = pulmonary embolism; PH = pulmonary hypertension; PVD = pulmonary vascular disease; PVR = pulmonary vascular resistance; SSc-ILD = scleroderma-associated interstitial lung disease.