Diabetes may raise odds for mortality in pulmonary hypertension

Key takeaways:

• Patients with pulmonary hypertension also presenting with diabetes faced high odds for mortality.
• More research is necessary to establish if these diseases are causally related.

HONOLULU — Patients with pulmonary hypertension who also had diabetes showed an increased likelihood for mortality compared with patients without diabetes, according to a systemic review presented at the CHEST Annual Meeting.

“To our knowledge, we believe that this is the first ever systematic review and meta-analysis conducted on this topic,” Smitesh S. Padte, MBBS, research scholar at Global Remote Research Scholars Program, said during his presentation.

Using PubMed and Embase, Padte and colleagues reviewed and assessed seven studies published during the last 10 years including 4,590 patients (67.2% women) with pulmonary hypertension (PH) to determine how diabetes impacts mortality among these individuals.

A majority of the studies were cohort studies, but one of the seven was a randomized controlled trial, Padte said.

Of the total cohort, 682 patients (mean age, 55.15 years) with PH also had diabetes, whereas 3,908 patients (mean age, 54.81 years) did not have this additional comorbidity.

Compared with patients who did not have diabetes, those with this comorbidity faced heightened odds for mortality (OR = 1.89; 95% CI, 1.28-2.8).

Because the researchers determined the studies in their analysis had high heterogeneity (I² = 66%), they conducted a sensitivity analysis that excluded one of the trials.

After doing so, heterogeneity went down to 15%, and researchers found even greater odds for mortality among those with vs. without diabetes (OR = 2.07; 95% CI, 1.58-2.7).

Notably, Padte highlighted three limitations of this review and meta-analysis when discussing these findings.

“[This is a] systematic review, so our data are observational; therefore, no causal inferences can be drawn to this,” he said during his presentation. “Out of the seven studies, some adjusted for factors like obesity and hypertension, while some did not. Finally, we also acknowledge that we searched only the main databases, like PubMed and Embase, but we did not search others like ... Scopus.

“Our research actually propels future research into the pathophysiological mechanisms of exactly how diabetes mellitus as a disease affects PH patients in regard to mortality, or with prognosis,” Padte added. “It might also propel future research into PH patients who had controlled or perhaps uncontrolled diabetes to see the difference in outcomes or difference in purposes.”