Lower DHEA-S levels predict disease and worse outcomes in post-menopausal women with idiopathic, connective tissue disease- And congenital heart diseaseassociated pulmonary arterial hypertension

Grayson L. Baird, Christine Archer-Chicko, R. Graham Barr, David A. Bluemke, Andrew E. Foderaro, Jason S. Fritz, Nicholas S. Hill, Steven M. Kawut, James R. Klinger, Joao A.C. Lima, Christopher J. Mullin, Pamela Ouyang, Harold I. Palevsky, Amy J. Palmisicano, Diane Pinder, Ioana R. Preston, Kari E. Roberts, K. Akaya Smith, Thomas Walsh, Mary WhittenhallCorey E. Ventetuolo

Research output: Contribution to journalArticlepeer-review

Abstract

High oestradiol (E2) and low dehydroepiandrosterone-sulfate (DHEA-S) levels are risk factors for pulmonary arterial hypertension (PAH) in men, but whether sex hormones are related to PAH in women is unknown. Post-menopausal women aged .55 years with PAH were matched by age and body mass index to women without cardiovascular disease. Plasma sex hormone levels were measured by immunoassay. Lower levels of DHEA-S (p<0.001) and higher levels of E2 (p=0.02) were associated with PAH. In PAH cases (n=112), lower DHEA-S levels were associated with worse haemodynamics (all p<0.01) and more right ventricular dilatation and dysfunction (both p=0.001). Lower DHEA-S levels were associated with shorter 6-min walking distance (6MWD) (p=0.01) and worse functional class (p=0.004). Each Ln(1 μg·dL-1) decrease in DHEA-S was associated with a doubling in the risk of death (hazard ratio 2.0, 95% CI 1.5-2.7; p<0.001). Higher levels of E2 were associated with shorter 6MWD (p=0.03) and worse functional class (p=0.01). High E2 and low DHEA-S levels are associated with the risk and severity of PAH in post-menopausal women. Hormonal modulation should be studied as a treatment strategy in PAH.

Original languageEnglish (US)
Article number1800467
JournalEuropean Respiratory Journal
Volume51
Issue number6
DOIs
StatePublished - 2018

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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