Temporal trends and drug exposures in pulmonary hypertension: An American experience

Alexander M. Walker, David Langleben*, James J. Korelitz, Stuart Rich, Lewis J. Rubin, Brian L. Strom, René Gonin, Susan Keast, David Badesch, Robyn J. Barst, Robert C. Bourge, Richard Channick, Adaani Frost, Sean Gaine, Michael McGoon, Vallerie McLaughlin, Srinivas Murali, Ronald J. Oudiz, Ivan M. Robbins, Victor TapsonLucien Abenhaim, Ginger Constantine

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


Background: Reports have linked anorexigen intake to an increased risk of pulmonary arterial hypertension (PAH). With the rise in anorexigen use in the latter half of the last decade, we established a surveillance network within the United States to monitor temporal trends in the number of reported cases of PAH. We also studied whether use of anorexigens and other drugs differed among patients with pulmonary hypertension of different etiologies. Methods: Newly diagnosed subjects (N = 1335) at 13 tertiary pulmonary hypertension centers were enrolled between January 1998 and June 2001. Patient-reported medication use was obtained by a telephone interview. Patients were classified as to the type of pulmonary hypertension. Poisson regression models were fitted to monthly case counts, and logistic regression methods were used to assess the association between type of pulmonary hypertension and medication use. Results: The average monthly number of reported cases of PAH and other categories of pulmonary hypertension did not change over the study period. Fenfluramine or dexfenfluramine use during the 5 years before the time of the interview was preferentially associated with PAH. Fenfluramine/dexfenfluramine use was particularly common in cases referred but found not to have pulmonary hypertension. Conclusions: No epidemic of anorexigen-related PAH was evident during the study period. As persons who had taken fenfluramine or dexfenfluramine were particularly likely to be referred for evaluation of pulmonary hypertension, it is unlikely that the failure to detect an anorexigen-induced rise in primary pulmonary hypertension was because of underascertainment. The association between fenfluramine derivatives and PAH is consistent with the risk elevations previously reported.

Original languageEnglish (US)
Pages (from-to)521-526
Number of pages6
JournalAmerican heart journal
Issue number3
StatePublished - Sep 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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