TY - JOUR T1 - Impact of age and comorbidity on risk stratification in idiopathic pulmonary arterial hypertension JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02310-2017 VL - 51 IS - 5 SP - 1702310 AU - Clara Hjalmarsson AU - Göran Rådegran AU - David Kylhammar AU - Bengt Rundqvist AU - Jonas Multing AU - Magnus D. Nisell AU - Barbro Kjellström A2 - , Y1 - 2018/05/01 UR - http://erj.ersjournals.com/content/51/5/1702310.abstract N2 - Recent reports from worldwide pulmonary hypertension registries show a new demographic picture for patients with idiopathic pulmonary arterial hypertension (IPAH), with an increasing prevalence among the elderly.We aimed to investigate the effects of age and comorbidity on risk stratification and outcome of patients with incident IPAH.The study population (n=264) was categorised into four age groups: 18–45, 46–64, 65–74 and ≥75 years. Individual risk profiles were determined according to a risk assessment instrument, based on the European Society of Cardiology and the European Respiratory Society guidelines. The change in risk group from baseline to follow-up (median 5 months) and survival were compared across age groups. In the two youngest age groups, a significant number of patients improved (18–45 years, Z= −4.613, p<0.001; 46–64 years, Z= −2.125, p=0.034), but no significant improvement was found in the older patient groups. 5-year survival was highest in patients aged 18–45 years (88%), while the survival rates were 63%, 56% and 36% for patients in the groups 46–64, 65–74 and ≥75 years, respectively (p<0.001). Ischaemic heart disease and kidney dysfunction independently predicted survival.These findings highlight the importance of age and specific comorbidities as prognostic markers of outcome in addition to established risk assessment algorithms.Change in risk category at follow-up and specific comorbidity predict survival in IPAH across age groups http://ow.ly/EPQ530j765F ER -