TY - JOUR T1 - Pulmonary arterial pressure during rest and exercise in healthy subjects: a systematic review JF - European Respiratory Journal JO - Eur Respir J SP - 888 LP - 894 DO - 10.1183/09031936.00145608 VL - 34 IS - 4 AU - G. Kovacs AU - A. Berghold AU - S. Scheidl AU - H. Olschewski Y1 - 2009/10/01 UR - http://erj.ersjournals.com/content/34/4/888.abstract N2 - According to current guidelines, pulmonary arterial hypertension (PAH) is diagnosed when mean pulmonary arterial pressure (P̄pa) exceeds 25 mmHg at rest or 30 mmHg during exercise. Issues that remain unclear are the classification of P̄pa values <25mmHg and whether P̄pa >30 mmHg during exercise is always pathological. We performed a comprehensive literature review and analysed all accessible data obtained by right heart catheter studies from healthy individuals to determine normal P̄pa at rest and during exercise. Data on 1,187 individuals from 47 studies in 13 countries were included. Data were stratified for sex, age, geographical origin, body position and exercise level. P̄pa at rest was 14.0±3.3 mmHg and this value was independent of sex and ethnicity. Resting P̄pa was slightly influenced by posture (supine 14.0±3.3 mmHg, upright 13.6±3.1 mmHg) and age (<30 yrs: 12.8± 3.1mmHg; 30–50 yrs: 12.9±3.0 mmHg; ≥50 yrs: 14.7±4.0 mmHg). P̄pa during exercise was dependent on exercise level and age. During mild exercise, P̄pa was 19.4±4.8 mmHg in subjects aged <50 yrs compared with 29.4±8.4 mmHg in subjects ≥50 yrs (p<0.001). In conclusion, while P̄pa at rest is virtually independent of age and rarely exceeds 20 mmHg, exercise P̄pa is age-related and frequently exceeds 30 mmHg, especially in elderly individuals, which makes it difficult to define normal P̄pa values during exercise. ER -