International Journal of COPD (Jun 2022)

The Incidence and Prevalence of Pulmonary Hypertension in the COPD Population: A Systematic Review and Meta-Analysis

  • Zhang L,
  • Liu Y,
  • Zhao S,
  • Wang Z,
  • Zhang M,
  • Zhang S,
  • Wang X,
  • Zhang S,
  • Zhang W,
  • Hao L,
  • Jiao G

Journal volume & issue
Vol. Volume 17
pp. 1365 – 1379

Abstract

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Limin Zhang,1 Yujia Liu,2 Shuai Zhao,1 Zhen Wang,1 Miaomiao Zhang,1 Su Zhang,1 Xinzhuo Wang,1 Shuang Zhang,1 Wenyan Zhang,1 Liying Hao,3 Guangyu Jiao1 1Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, People’s Republic of China; 2College of Traditional Chinese Medicine, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, 110032, People’s Republic of China; 3Department of Pharmaceutical Pharmacology and Toxicology, China Medical University, Shenyang, Liaoning, 110000, People’s Republic of ChinaCorrespondence: Guangyu Jiao, Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Sanhao Street, Shenyang, Liaoning, 110004, People’s Republic of China, Tel +8618940251105, Email [email protected]: Chronic obstructive pulmonary disease (COPD)-related pulmonary hypertension (PH) is one of the most common comorbidities of COPD, and often leads to a worse prognosis. Although the estimated prevalence and risk factors of COPD-related PH have been widely reported, these results have not been well integrated. This study aimed to review the worldwide incidence and prevalence of COPD-related PH and explore possible factors affecting its prevalence.Patients and Methods: We searched four electronic databases (Web of Science, Embase, Cochrane, and MEDLINE) to identify all observational studies on the prevalence of COPD-related PH from database creation until July 20, 2021. Eligibility screening, quality assessment, and data extraction of the retrieved studies were independently conducted by two reviewers. Meta-analyses were performed to determine the prevalence of PH in the COPD population. Random-effects meta-regression model analyses were conducted to investigate the sources of heterogeneity.Results: Altogether, 38 articles were included in the meta-analyses. The pooled prevalence was 39.2% (95% CI: 34.0– 44.4, I2 = 97.6%) for COPD-related PH. Subgroup analyses showed that the prevalence of PH increased with COPD severity, where the majority (30.2%) had mild PH and the minority had severe PH (7.2%). Furthermore, we found a significant regional difference in the prevalence of COPD-related PH (P = 0.000), which was the highest in Africa (64.0%) and the lowest in Europe (30.4%). However, stratified studies on other factors involving mean age, sex, enrolment time, participant recruitment settings, and PH diagnostic methods showed no significant differences in prevalence (P > 0.05).Conclusion: The global incidence of PH in the COPD population is very high, and there are significant regional and international variations. Patients with COPD should be screened for PH and contributing risk factors to reduce the burden on individuals and society.Keywords: chronic obstructive pulmonary disease, pulmonary hypertension, prevalence, heterogeneity, meta-analysis

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