Study of the causes of high pulmonary arterial pressure at Damascus Hospital

Study of the causes of high pulmonary arterial pressure at Damascus Hospital | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Study of the causes of high pulmonary arterial pressure at Damascus Hospital Sedra saffaf, Lilas Al Arnaoot Romelley, Heba Almardine This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4518319/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction Pulmonary hypertension refers to high blood pressure in the pulmonary arteries that carry oxygen-poor blood from the heart to the lungs with a mean pulmonary artery pressure of ≥ 25 mm Hg. Materials and methods A descriptive study was conducted on a sample of 246 patients attending Damascus Hospital. Their pulmonary pressure was measured, and several axes related to high pulmonary pressure were studied, including general medical antecedents and then studying the final diagnosis of the cause. A descriptive study of the sample was conducted and then an analytical study that served the research objectives. Results A sample size of 248 patients was collected from the patients attending Damascus Hospital, of which the percentage of males was 51.6%, while the percentage of females was 48.4%. The age of the largest percentage of the sample, about 54.9%, was in the category (61 to 90 years). The percentage of smokers in the sample was 46.7%, about 2.8% of the sample, recorded that they were alcoholic. The majority of the sample recorded that they suffer from several conditions together, at a rate of 65.6%, about 70.3%, recorded no history of surgery. 75.2% of the sample recorded that they suffer from heart disorders, While 15.9% of the sample had disorders and problems in the respiratory system. The vast majority of the sample, 90.2%, had an elevated pulmonary pressure of more than 25 mmHg. the most common cause (final diagnosis) was heart failure, 35.3% . Conclusion • Women were found to be at risk of having high pulmonary pressure with a risk factor of 1.5% more than men • While the results of the one-way analysis of variance test showed that there is a significant effect and an important correlation between the patient’s age and high pulmonary pressure, as the risk increases with a risk factor of 0.43% as age increases. • There is an important correlation and significant effect of smoking on the degree of pulmonary hypertension. • There is an important correlation and significant effect of alcohol consumption on the degree of pulmonary hypertension. • There is an important, statistically significant correlation to the presence of heart disease in the patient and high pulmonary pressure, as heart patients are at risk of having high pulmonary pressure with a risk factor of 1.12% more than patients without heart disease. • Patients with respiratory problems and disorders are at risk of developing pulmonary hypertension, with a risk factor of 1.36%. • There is an important, significant correlation between taking medications (antidepressants, appetite suppressants) and the degree of pulmonary hypertension. • There is an important correlation between the final diagnosis and the cases reported as causes of pulmonary hypertension. Cardiac & Cardiovascular Systems pulmonary arterial pressure Damascus Introduction Pulmonary hypertension refers to high blood pressure in the pulmonary arteries that carry oxygen-poor blood from the heart to the lungs. It has many different causes, and is usually a complication of heart disease or lung disease. Pulmonary hypertension is not a diagnosis in itself, but merely a hemodynamic condition characterized by a mean pulmonary artery pressure (PAP m ) of ≥ 25 mm Hg. Pulmonary hypertension is more common among older people, with about 1 in 10 adults over the age of 65 having pulmonary hypertension. It can be caused by several different factors, including unhealthy habits, limited physical activity, obesity, psychological stress, and genetics. In turn, high pulmonary pressure leads to serious health problems such as cardiovascular disease, strokes, and kidney disease. Therefore, it is important to follow a healthy diet, exercise regularly, avoid smoking, and manage stress effectively to maintain healthy blood pressure. In cases of chronic high blood pressure, you may need to take medications to help lower it Symptoms of high pulmonary pressure appear, such as fatigue, difficulty breathing, chest pain, and a decrease in endurance. As the disease progresses, the symptoms worsen to include shortness of breath, a feeling of fatigue, dizziness, fainting spells, widespread edema, swelling of the ankles, and blue lips and skin. Current treatment includes supplemental oxygen, diuretics, anticoagulants, calcium channel blockers, prostanoids, endothelin receptor antagonists, phosphodiesterase 5 inhibitors, or interventional and surgical procedures. Materials and methods Research objective: A descriptive study was conducted on a sample of 246 patients attending Damascus Hospital. The aim of the research was to study the causes of pulmonary hypertension diagnosed with echocardiography. Place of the study: The study was conducted in Damascus - Damascus Hospital. The sample consisted of 246 patients admitted to Damascus Hospital. Questionnaire topics A. The first axis: characteristics of participants: It included 4 questions about gender, age, smoking, and Alcohol consumption. B. The second axis: the value of the pulmonary pressure. C. The third axis: several aspects related to high pulmonary pressure were studied, including general medical antecedents (liver, endocrine, and immune diseases), the presence of cardiovascular diseases, respiratory disorders, taking medications that cause high pulmonary pressure (appetite suppressants, antidepressants and anti-anxiety drugs), and then studying the final diagnosis of the cause. Statistical study : The data was processed using the SPSS program, version 26, according to the appropriate statistical methods for the data. A descriptive study of the sample was conducted and then an analytical study that served the research objectives. The statistical methods used include the Student test for independent samples, a one-way analysis of variance test, pivot tables, and a study of the relative risk factor. Results Demographic results A descriptive study was conducted on a sample of 246 patients attending Damascus Hospital. The percentage of males in the sample was 52%, while the percentage of females was approximately 48%. The prevailing age group is between 60-90 years. The percentage of smokers and non-smokers is close, and most of the sample members are non-alcoholic. Descriptive results Most of the sample members (approximately 90%) suffer from high pulmonary pressure, and most of them have medical histories of more than one condition combined. Three-quarters of the sample suffer from heart diseases, but only 15% have respiratory diseases. Approximately 70% of the sample has not undergone any previous surgery, and about half The sample took medications that cause high pulmonary pressure (antidepressants and appetite suppressants). The majority were diagnosed with heart failure, or atrial fibrillation, or pulmonary embolism. Analytical study Note that 90.8% of women have high pulmonary pressure, while 10.2% of males have normal pulmonary pressure, and we note that women are more susceptible to have high pulmonary pressure than men, with a risk of 1.05%. To study the correlation between the patient's age and pulmonary hypertension, we tested a one-way analysis of variance and discussed the results in the table based on the probability value (P-value < 0.05). Therefore, there is an important correlation and a significant effect between the patient's age and pulmonary hypertension. Note that the percentages of patients increase as age increases, as the percentages, respectively (less than 29, between 30 to 60, between 61 to 90, and more than 90) are (83.3%, 85.4%, 94.1%, 100.0%), with a risk factor of 0.435 %. That is, as age increases, pulmonary hypertension increases with a risk rate of 0.435%. To study the correlation between smoking and high pulmonary pressure, we conducted a Student test for independent samples and discussed the results in the table based on the probability value (P-value < 0.05). Therefore, there is an important correlation and a significant effect of smoking on the degree of pulmonary hypertension. To study the correlation between alcohol and high pulmonary pressure, we conducted a Student test for independent samples. By discussing the results presented in the table, we notice that there are differences in the means. Based on the probability value mentioned in the table (P-value < 0.05), we notice that these differences have a significant impact, and therefore there is an important correlation and a significant effect of alcohol on the degree of pulmonary hypertension. To study the correlation between the presence of cardiovascular diseases and high pulmonary pressure, we conducted a Student test for independent samples. By discussing the results presented in the table, we notice that there are differences in the means. Based on the probability value mentioned in the table (P-value < 0.05), we notice that these differences have a moral significance, and therefore there is an important correlation and Significant effect for the presence of cardiovascular disease on the degree of pulmonary hypertension. According to the information contained in the next axial table, we note that the largest percentage of participants with heart diseases suffer from high pulmonary pressure, as 89.2% of participants with cardiovascular diseases suffer from high pulmonary pressure, with a risk factor of 1.12%, meaning that heart patients are at risk of developing high pulmonary pressure at a risk rate 1.12% more than people who do not have any cardiovascular problems. To study the correlation between taking medications (antidepressants and appetite suppressants) and high pulmonary pressure, we conducted a Student test for independent samples, by discussing the results presented in the table, we notice that there are differences in the means. Based on the probability value mentioned in the table (P-value < 0.05), we notice that these differences have a moral significance, and therefore there is an important correlation and a moral effect for taking these medications for high pulmonary pressure. To study the correlation between the final diagnosis and pulmonary hypertension, we tested a one-way analysis of variance and discussed the results in the table based on the probability value (P-value < 0.05). Therefore, there is an important correlation and a significant effect between the diagnosis (cardiogenic shock - heart failure - atrial fibrillation - COPD....) and the degree and elevation of pulmonary pressure. Note that the largest percentage of participants who suffer from these conditions suffer from high pulmonary pressure, as 96% of heart failure patients suffer from high pulmonary pressure and 85% of atrial fibrillation patients suffer from high blood pressure. Discussion A sample size of 248 patients was collected from the patients attending Damascus Hospital, of which the percentage of males was 51.6%, while the percentage of females was 48.4%. The sample was divided into 4 age groups, and the age of the largest percentage of the sample, about 54.9%, was in the category (61 to 90 years), followed by about 41.9% of the sample, whose ages ranged from 30 to 60 years. The percentage of smokers in the sample was 46.7%, while 48.4% were non-smokers, and 4.9% were former smokers. As for alcohol, a very small percentage, about 2.8% of the sample, recorded that they were alcoholic. Regarding medical history (diabetes, heart disease, respiratory disease...), we note that the majority of the sample recorded that they suffer from several conditions together, at a rate of 65.6%. 75.2% of the sample recorded that they suffer from heart disorders (heart failure, high blood pressure, aortic insufficiency,...) While 15.9% of the sample had disorders and problems in the respiratory system (asthma, pleural effusion, obstructive lung diseases...), the largest percentage of the sample, about 70.3%, recorded no history of surgery. We were asked about taking some medications involved in high pulmonary pressure (antidepressants and appetite suppressants), and 54.4% of the sample recorded that they were taking these medications. Then, the participants’ pulmonary pressure measurements were recorded, and we note that the vast majority of the sample, 90.2%, had an elevated pulmonary pressure of more than 25 mmHg. In the final diagnosis of the study of cases causing pulmonary hypertension, it was found that the most common cause was heart failure, followed by atrial fibrillation, at rates of 35.3% and 19.4%, respectively. According to webmed, pulmonary hypertension may result from several factors, including health conditions that cause damage to the lungs, the left side of your heart, or the pulmonary arteries. But determining the causes of pulmonary hypertension can be difficult, and sometimes a specific cause is not identified. Conclusion • Women were found to be at risk of having high pulmonary pressure with a risk factor of 1.5% more than men • While the results of the one-way analysis of variance test showed that there is a significant effect and an important correlation between the patient’s age and high pulmonary pressure, as the risk increases with a risk factor of 0.43% as age increases. • There is an important correlation and significant effect of smoking on the degree of pulmonary hypertension. • There is an important correlation and significant effect of alcohol consumption on the degree of pulmonary hypertension. • There is an important, statistically significant correlation to the presence of heart disease in the patient and high pulmonary pressure, as heart patients are at risk of having high pulmonary pressure with a risk factor of 1.12% more than patients without heart disease. • Patients with respiratory problems and disorders are at risk of developing pulmonary hypertension, with a risk factor of 1.36%. • There is an important, significant correlation between taking medications (antidepressants, appetite suppressants) and the degree of pulmonary hypertension. • There is an important correlation between the final diagnosis and the cases reported as causes of pulmonary hypertension. These results are in line with other international studies, as Dr. Reem Al-Qurashi, Professor of Chest Diseases at Kasr Al-Ainy Faculty of Medicine, indicated that recent studies on the disease have shown a high incidence of pulmonary hypertension among women aged thirty and forty, and that the diseases of lupus erythematosus and skin induration, Patients with congenital heart defects, or patients with liver cirrhosis, must be followed up periodically to ensure that they do not suffer from pulmonary hypertension. On February 17-19, the fifteenth conference of the Saudi Pulmonary Hypertension Society was held in Jeddah, with the participation of scientists and specialists from many European, Arab and Gulf countries, along with doctors from the Kingdom. It was indicated that the disease affects people of all ages, including children, and the incidence rate may increase to 10 percent in individuals over the age of 65 years. The US Food and Drug Administration has warned health care providers of new findings regarding the risks resulting from stopping or continuing use of depression medications during pregnancy. A warning was sent from the US Food and Drug Administration's MedWatch Center based on a study conducted on women using serotonin-reducing medications (SSRIs) or other medications to treat depression (in a number of cases). The study showed that there may be small risks resulting from the use of drugs that increase serotonin levels during pregnancy. This study focused on newborns with permanent pulmonary hypertension, which is a dangerous and life-threatening condition, as newborns in this condition suffer from high blood pressure in the blood vessels of the lung, which leads to a lack of oxygen in the blood circulation. It has been shown that the use of serotonin-raising medications during the first twenty weeks of pregnancy has increased the incidence of permanent pulmonary hypertension by six times in newborns. Permanent pulmonary hypertension occurs in newborns at a rate of one to two children per thousand births, and it often causes acute respiratory failure, which requires rapid medical intervention. Although the study was small to determine the risks of each drug alone and there are no other studies examining these risks, the US Food and Drug Administration noted that there are potential risks that could be added to the questions related to the safety of serotonin-raising drugs resulting from their use during pregnancy. It must be taken into consideration that mothers’ use of serotonin-raising medications during the second half of pregnancy may lead to permanent pulmonary hypertension in newborns, due to the presence of previous reports showing that mothers’ use of these medications during the late period of pregnancy (third trimester) led to the appearance of some Symptoms in newborns include irritability, difficulty eating, and rare cases of difficulty breathing. Declarations Ethics approval and consent to participate. All methods were carried out in accordance with relevant guidelines and regulations. Ethical approval for the current study has been obtained from the Syrian Ethical Society for Scientific Research (NSMN 6464674). Informed consent was obtained from all subjects. Consent for publication Not applicable. Competing interests None Funding N/A Availability of Data and Materials The authors have access to and have saved all of the data necessary to support this paper's conclusion. All data are accessible upon reasonable request from the corresponding author. References Galie N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2016;37:67–119. Hoeper MM, Humbert M, Souza R, et al. A global view of pulmonary hypertension. Lancet Respir Med. 2016;4:306–322 Opitz C, Hoeper MM, Gibbs JSR, et al. Pre-capillary, combined, and post-capillary pulmonary hypertension: a pathophysiological continuum? J Am Coll Cardiol. 2016;68:368–378. American Academy of Family Physicians. Pulmonary Hypertension ( https://familydoctor.org/condition/pulmonary- hypertension/?adfree=true) . Accessed 6/2/2022. Bhogal S, Mukherjee D, Banerjee S, Islam AM, Daggubati R, Paul TK. Current trends and future perspectives in the treatment of pulmonary hypertension: WHO Group II-V (https://pubmed.ncbi.nlm.nih.gov/29153390/) . Curr Probl Cardiol . 2018 May;43(5):217-231. Accessed 6/2/2022 European Pulmonary Hypertension Association. Classification and WHO Functional Class (https://www.phaeurope.org/about-ph/classification-and-who-functional-class/) . Accessed 6/2/2022. Pulmonary Hypertension Association. Multiple pages ( https://phassociation.org/types- pulmonary-hypertension-groups/) . Accessed 6/2/2022 United Kingdom, National Health Service. Pulmonary Hypertension (https://www.nhs.uk/conditions/pulmonary-hypertension/) . Accessed 6/2/2022 Voelkel N. F., Tuder R. M., Weir E. K. Pathophysiology of primary pulmonary hypertension. Primary pulmonary hypertension., L. J Rubin, S Rich, editors. Marcel Dekker, New York 1997; p. 83–12. Tuder R. M., Cool C. D., Geraci M. W., Wang J., Abman S. H., Wright L., et al. Prostacyclin synthase expression is decreased in lungs from patients with severs pulmonary hypertension. Am J Respir Crit Care Med 1999; 159: 1925–32 Tuder R. M., Flook B. E., Voelkel N. F. Increased gene expression for VEGF and the VEGF receptors KDR/Flk and Flt in lungs exposed to acute or chronic hypoxia: modulation of gene expression by nitric oxide. J Clin Invest 1995; 95: 1798–807 Khan MS, Memon MM, Amin E, et al. Use of balloon atrial septostomy in patients with advanced pulmonary arterial hypertension: A systematic review and meta-analysis (https://pubmed.ncbi.nlm.nih.gov/30910639/) . Chest . 2019 Jul;156(1):53-63. Accessed 6/2/2022. Wijeratne DT, Lajkosz K, Brogly SB, et al. Increasing incidence and prevalence of World Health Organization Groups 1 to 4 pulmonary hypertension: A population-based cohort study in Ontario, Canada (https://pubmed.ncbi.nlm.nih.gov/29444925/) . Circ Cardiovasc Qual Outcomes . 2018 Feb;11(2):e003973. Accessed 6/2/2022. United Kingdom, National Health Service. Pulmonary Hypertension (https://www.nhs.uk/conditions/pulmonary-hypertension/) . Accessed 6/2/2022. Dumas J. P., Bardou M., Goirand F., Dumas M. Hypoxic pulmonary vasoconstriction. Gen Pharmacol 1999; 33: 289–97 Sweeney M., Yuan J. X. Hypoxic pulmonary vasoconstriction: role of voltage‐gated potassium channels. Respir Res 2000; 1: 40–8 Deng Z., Morse J. H., Slager S. L., Cuervo N., Moore K. J., Venetos G., et al. Familial primary pulmonary hypertension (gene PPH1) is caused by mutations in the bone morphogenetic protein receptor‐II gene. Am J Hum Genet 2000; 67: 737–44 Rich S., Brundage B. H. High‐dose calcium channel‐blocking therapy for primary pulmonary hypertension: evidence for long‐term reduction in pulmonary arterial pressure and regression of right ventricular hypertrophy. Circulation 1987; 76: 135–41 Raffy O., Azarian R., Brenot F., Parent F., Sitbon O., Petitpretz P., et al. Clinical significance of the pulmonary vasodilator response during short‐term infusion of prostacyclin in primary pulmonary hypertension. Circulation 1996; 93: 484–8 Rubin L. J., Mendoza J., Hood M., McGoon M., Barst R., Williams W. B., et al. Treatment of primary pulmonary hypertension with continuous intravenous prostacyclin (epoprostenol). Results of a randomized trial. Ann Intern Med 1990; 112: 485–91 Nootens M., Kaufmann E., Rich S. Short‐term effectiveness of nifedipine in secondary pulmonary hypertension. Am J Cardiol 1993; 71: 1475–6 Oleschewski H., Ghofrani H. A., Schmehl T., Winkleer J., Wilkens H., Hoper M. M., et al. Inhaled iloprost to treat severe pulmonary hypertension. An uncontrolled trial. German PPH Study Group. Ann Intern Med 2000; 132: 435–43 Barst R. J., Langleben D., Frost A., Horn E. M., Oudiz R., Shapiro S., et al. Sitaxsentan therapy for pulmonary arterial hypertension. Am J Respir Crit Care Med 2004; 169: 441 24. Sandoval J., Gaspar J., Pulido, Bautista E., Martinez‐Guerra M. L., Zeballos M., et al. Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension. A therapeutic alternative for patients non‐responsive to vasodilator treatment. J Am Coll Cardiol 1998; 32: 297–304 Tables Table 8 is not available with this version Tables 1 to 7 and 9-10 are available in the Supplementary Files section. Additional Declarations The authors declare no competing interests. Supplementary Files Tables.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4518319","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":309687529,"identity":"407dd7bd-a232-4396-9f4b-981ef917728e","order_by":0,"name":"Sedra saffaf","email":"","orcid":"","institution":"Faculty of Medicine; Syrian private university (SPU), Damascus, Syria","correspondingAuthor":false,"prefix":"","firstName":"Sedra","middleName":"","lastName":"saffaf","suffix":""},{"id":309687554,"identity":"abd15fad-9665-48ef-b93e-01af35bd3862","order_by":1,"name":"Lilas Al Arnaoot Romelley","email":"","orcid":"","institution":"aculty of Medicine; Syrian private university (SPU), Damascus, Syria","correspondingAuthor":false,"prefix":"","firstName":"Lilas","middleName":"Al Arnaoot","lastName":"Romelley","suffix":""},{"id":309687555,"identity":"d187ac02-bb52-48ff-b9bf-457c116c4e11","order_by":2,"name":"Heba Almardine","email":"data:image/png;base64,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","orcid":"","institution":"Faculty of Medicine; Damascus university, Damascus, Syria","correspondingAuthor":true,"prefix":"","firstName":"Heba","middleName":"","lastName":"Almardine","suffix":""}],"badges":[],"createdAt":"2024-06-02 21:14:52","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4518319/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4518319/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":57792289,"identity":"ee3c8497-be52-4a24-aa9d-62c37e6a9692","added_by":"auto","created_at":"2024-06-05 17:54:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":296049,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4518319/v1/63dbbee6-2ac2-4b25-aa4c-949b83cba478.pdf"},{"id":57792288,"identity":"8e595c85-4788-42dd-9a18-abf8d6d8ca68","added_by":"auto","created_at":"2024-06-05 17:54:46","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":25676,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-4518319/v1/303e81e268f34f8773e6ac54.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eStudy of the causes of high pulmonary arterial pressure at Damascus Hospital\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePulmonary hypertension refers to high blood pressure in the pulmonary arteries that carry oxygen-poor blood from the heart to the lungs. It has many different causes, and is usually a complication of heart disease or lung disease. Pulmonary hypertension is not a diagnosis in itself, but merely a hemodynamic condition characterized by a mean pulmonary artery pressure (PAP\u003csub\u003em\u003c/sub\u003e) of \u0026ge;\u0026thinsp;25 mm Hg.\u003c/p\u003e \u003cp\u003ePulmonary hypertension is more common among older people, with about 1 in 10 adults over the age of 65 having pulmonary hypertension. It can be caused by several different factors, including unhealthy habits, limited physical activity, obesity, psychological stress, and genetics. In turn, high pulmonary pressure leads to serious health problems such as cardiovascular disease, strokes, and kidney disease. Therefore, it is important to follow a healthy diet, exercise regularly, avoid smoking, and manage stress effectively to maintain healthy blood pressure. In cases of chronic high blood pressure, you may need to take medications to help lower it Symptoms of high pulmonary pressure appear, such as fatigue, difficulty breathing, chest pain, and a decrease in endurance. As the disease progresses, the symptoms worsen to include shortness of breath, a feeling of fatigue, dizziness, fainting spells, widespread edema, swelling of the ankles, and blue lips and skin. Current treatment includes supplemental oxygen, diuretics, anticoagulants, calcium channel blockers, prostanoids, endothelin receptor antagonists, phosphodiesterase 5 inhibitors, or interventional and surgical procedures.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003e\u003cstrong\u003eResearch objective:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive study was conducted on a sample of 246 patients attending Damascus Hospital. The aim of the research was to study the causes of pulmonary hypertension diagnosed with echocardiography.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePlace of the study:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The study was conducted in Damascus - Damascus Hospital. The sample consisted of 246 patients admitted to Damascus Hospital.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuestionnaire topics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.\u0026nbsp;\u0026nbsp;The first axis: characteristics of participants: It included 4 questions about gender, age, smoking, and Alcohol consumption.\u003c/p\u003e\n\u003cp\u003eB.\u0026nbsp;\u0026nbsp;The second axis: the value of the pulmonary pressure.\u003c/p\u003e\n\u003cp\u003eC.\u0026nbsp; \u0026nbsp;\u0026nbsp;The third axis: several aspects related to high pulmonary pressure were studied, including general medical antecedents \u0026nbsp;(liver, endocrine, and immune diseases), \u0026nbsp;the presence of cardiovascular diseases, respiratory disorders, taking medications that cause high pulmonary pressure (appetite suppressants, antidepressants and anti-anxiety drugs), and then studying the final diagnosis of the cause.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical study\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data was processed using the SPSS program, version 26, according to the appropriate statistical methods for the data. A descriptive study of the sample was conducted and then an analytical study that served the research objectives. The statistical methods used include the Student test for independent samples, a one-way analysis of variance test, pivot tables, and a study of the relative risk factor.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eDemographic results\u003c/p\u003e\n\u003cp\u003eA descriptive study was conducted on a sample of 246 patients attending Damascus Hospital. The percentage of males in the sample was 52%, while the percentage of females was approximately 48%. The prevailing age group is between 60-90 years. The percentage of smokers and non-smokers is close, and most of the sample members are non-alcoholic.\u003c/p\u003e\n\u003cp\u003eDescriptive results\u003c/p\u003e\n\u003cp\u003eMost of the sample members (approximately 90%) suffer from high pulmonary pressure, and most of them have medical histories of more than one condition combined. Three-quarters of the sample suffer from heart diseases, but only 15% have respiratory diseases. Approximately 70% of the sample has not undergone any previous surgery, and about half The sample took medications that cause high pulmonary pressure (antidepressants and appetite suppressants). The majority were diagnosed with heart failure, or atrial fibrillation, or pulmonary embolism.\u003c/p\u003e\n\u003cp\u003eAnalytical study\u003c/p\u003e\n\u003cp\u003eNote that 90.8% of women have high pulmonary pressure, while 10.2% of males have normal pulmonary pressure, and we note that women are more susceptible to have high pulmonary pressure than men, with a risk of 1.05%.\u003c/p\u003e\n\u003cp\u003eTo study the correlation between the patient\u0026apos;s age and pulmonary hypertension, we tested a one-way analysis of variance and discussed the results in the table based on the probability value (P-value \u0026lt; 0.05). Therefore, there is an important correlation and a significant effect between the patient\u0026apos;s age and pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003eNote that the percentages of patients increase as age increases, as the percentages, respectively (less than 29, between 30 to 60, between 61 to 90, and more than 90) are (83.3%, 85.4%, 94.1%, 100.0%), with a risk factor of 0.435 %.\u003c/p\u003e\n\u003cp\u003eThat is, as age increases, pulmonary hypertension increases with a risk rate of 0.435%.\u003c/p\u003e\n\u003cp\u003eTo study the correlation between smoking and high pulmonary pressure, we conducted a Student test for independent samples and discussed the results in the table based on the probability value (P-value \u0026lt; 0.05). Therefore, there is an important correlation and a significant effect of smoking on the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003eTo study the correlation between alcohol and high pulmonary pressure, we conducted a Student test for independent samples. By discussing the results presented in the table, we notice that there are differences in the means. Based on the probability value mentioned in the table (P-value \u0026lt; 0.05), we notice that these differences have a significant impact, and therefore there is an important correlation and a significant effect of alcohol on the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003eTo study the correlation between the presence of cardiovascular diseases and high pulmonary pressure, we conducted a Student test for independent samples. By discussing the results presented in the table, we notice that there are differences in the means. Based on the probability value mentioned in the table (P-value \u0026lt; 0.05), we notice that these differences have a moral significance, and therefore there is an important correlation and Significant effect for the presence of cardiovascular disease on the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003eAccording to the information contained in the next axial table, we note that the largest percentage of participants with heart diseases suffer from high pulmonary pressure, as 89.2% of participants with cardiovascular diseases suffer from high pulmonary pressure, with a risk factor of 1.12%, meaning that heart patients are at risk of developing high pulmonary pressure at a risk rate 1.12% more than people who do not have any cardiovascular problems.\u003c/p\u003e\n\u003cp\u003eTo study the correlation between taking medications (antidepressants and appetite suppressants) and high pulmonary pressure, we conducted a Student test for independent samples, by discussing the results presented in the table, we notice that there are differences in the means. Based on the probability value mentioned in the table (P-value \u0026lt; 0.05), we notice that these differences have a moral significance, and therefore there is an important correlation and a moral effect for taking these medications for high pulmonary pressure.\u003c/p\u003e\n\u003cp\u003eTo study the correlation between the final diagnosis and pulmonary hypertension, we tested a one-way analysis of variance and discussed the results in the table based on the probability value (P-value \u0026lt; 0.05). Therefore, there is an important correlation and a significant effect between the diagnosis (cardiogenic shock - heart failure - atrial fibrillation - COPD....) and the degree and elevation of pulmonary pressure.\u003c/p\u003e\n\u003cp\u003eNote that the largest percentage of participants who suffer from these conditions suffer from high pulmonary pressure, as 96% of heart failure patients suffer from high pulmonary pressure and 85% of atrial fibrillation patients suffer from high blood pressure.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eA sample size of 248 patients was collected from the patients attending Damascus Hospital, of which the percentage of males was 51.6%, while the percentage of females was 48.4%.\u003c/p\u003e \u003cp\u003e The sample was divided into 4 age groups, and the age of the largest percentage of the sample, about 54.9%, was in the category (61 to 90 years), followed by about 41.9% of the sample, whose ages ranged from 30 to 60 years.\u003c/p\u003e \u003cp\u003eThe percentage of smokers in the sample was 46.7%, while 48.4% were non-smokers, and 4.9% were former smokers. As for alcohol, a very small percentage, about 2.8% of the sample, recorded that they were alcoholic.\u003c/p\u003e \u003cp\u003eRegarding medical history (diabetes, heart disease, respiratory disease...), we note that the majority of the sample recorded that they suffer from several conditions together, at a rate of 65.6%.\u003c/p\u003e \u003cp\u003e75.2% of the sample recorded that they suffer from heart disorders (heart failure, high blood pressure, aortic insufficiency,...)\u003c/p\u003e \u003cp\u003eWhile 15.9% of the sample had disorders and problems in the respiratory system (asthma, pleural effusion, obstructive lung diseases...), the largest percentage of the sample, about 70.3%, recorded no history of surgery.\u003c/p\u003e \u003cp\u003eWe were asked about taking some medications involved in high pulmonary pressure (antidepressants and appetite suppressants), and 54.4% of the sample recorded that they were taking these medications.\u003c/p\u003e \u003cp\u003eThen, the participants\u0026rsquo; pulmonary pressure measurements were recorded, and we note that the vast majority of the sample, 90.2%, had an elevated pulmonary pressure of more than 25 mmHg.\u003c/p\u003e \u003cp\u003eIn the final diagnosis of the study of cases causing pulmonary hypertension, it was found that the most common cause was heart failure, followed by atrial fibrillation, at rates of 35.3% and 19.4%, respectively.\u003c/p\u003e \u003cp\u003eAccording to webmed, pulmonary hypertension may result from several factors, including health conditions that cause damage to the lungs, the left side of your heart, or the pulmonary arteries. But determining the causes of pulmonary hypertension can be difficult, and sometimes a specific cause is not identified.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;Women were found to be at risk of having high pulmonary pressure with a risk factor of 1.5% more than men\u003c/p\u003e\n\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;While the results of the one-way analysis of variance test showed that there is a significant effect and an important correlation between the patient’s age and high pulmonary pressure, as the risk increases with a risk factor of 0.43% as age increases.\u003c/p\u003e\n\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;There is an important correlation and significant effect of smoking on the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;There is an important correlation and significant effect of alcohol consumption on the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;There is an important, statistically significant correlation to the presence of heart disease in the patient and high pulmonary pressure, as heart patients are at risk of having high pulmonary pressure with a risk factor of 1.12% more than patients without heart disease.\u003c/p\u003e\n\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;Patients with respiratory problems and disorders are at risk of developing pulmonary hypertension, with a risk factor of 1.36%.\u003c/p\u003e\n\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;There is an important, significant correlation between taking medications (antidepressants, appetite suppressants) and the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003e•\u0026nbsp; \u0026nbsp;\u0026nbsp;There is an important correlation between the final diagnosis and the cases reported as causes of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003eThese results are in line with other international studies, as Dr. Reem Al-Qurashi, Professor of Chest Diseases at Kasr Al-Ainy Faculty of Medicine, indicated that recent studies on the disease have shown a high incidence of pulmonary hypertension among women aged thirty and forty, and that the diseases of lupus erythematosus and skin induration, Patients with congenital heart defects, or patients with liver cirrhosis, must be followed up periodically to ensure that they do not suffer from pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003eOn February 17-19, the fifteenth conference of the Saudi Pulmonary Hypertension Society was held in Jeddah, with the participation of scientists and specialists from many European, Arab and Gulf countries, along with doctors from the Kingdom.\u003c/p\u003e\n\u003cp\u003eIt was indicated that the disease affects people of all ages, including children, and the incidence rate may increase to 10 percent in individuals over the age of 65 years.\u003c/p\u003e\n\u003cp\u003eThe US Food and Drug Administration has warned health care providers of new findings regarding the risks resulting from stopping or continuing use of depression medications during pregnancy.\u003c/p\u003e\n\u003cp\u003eA warning was sent from the US Food and Drug Administration's MedWatch Center based on a study conducted on women using serotonin-reducing medications (SSRIs) or other medications to treat depression (in a number of cases).\u003c/p\u003e\n\u003cp\u003eThe study showed that there may be small risks resulting from the use of drugs that increase serotonin levels during pregnancy.\u003c/p\u003e\n\u003cp\u003eThis study focused on newborns with permanent pulmonary hypertension, which is a dangerous and life-threatening condition, as newborns in this condition suffer from high blood pressure in the blood vessels of the lung, which leads to a lack of oxygen in the blood circulation.\u003c/p\u003e\n\u003cp\u003eIt has been shown that the use of serotonin-raising medications during the first twenty weeks of pregnancy has increased the incidence of permanent pulmonary hypertension by six times in newborns.\u003c/p\u003e\n\u003cp\u003ePermanent pulmonary hypertension occurs in newborns at a rate of one to two children per thousand births, and it often causes acute respiratory failure, which requires rapid medical intervention.\u003c/p\u003e\n\u003cp\u003eAlthough the study was small to determine the risks of each drug alone and there are no other studies examining these risks, the US Food and Drug Administration noted that there are potential risks that could be added to the questions related to the safety of serotonin-raising drugs resulting from their use during pregnancy.\u003c/p\u003e\n\u003cp\u003eIt must be taken into consideration that mothers’ use of serotonin-raising medications during the second half of pregnancy may lead to permanent pulmonary hypertension in newborns, due to the presence of previous reports showing that mothers’ use of these medications during the late period of pregnancy (third trimester) led to the appearance of some Symptoms in newborns include irritability, difficulty eating, and rare cases of difficulty breathing.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll methods were carried out in accordance with relevant guidelines and regulations.\u0026nbsp;Ethical approval for the current study has been obtained from the Syrian Ethical Society for Scientific Research (NSMN 6464674). Informed consent was obtained from all subjects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eN/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have access to and have saved all of the data necessary to support this paper's conclusion. All data are accessible upon reasonable request from the corresponding author.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGalie N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. \u003cem\u003eEur Heart J. \u003c/em\u003e2016;37:67\u0026ndash;119.\u003c/li\u003e\n\u003cli\u003eHoeper MM, Humbert M, Souza R, et al. A global view of pulmonary hypertension. \u003cem\u003eLancet Respir Med. \u003c/em\u003e2016;4:306\u0026ndash;322\u003c/li\u003e\n\u003cli\u003eOpitz C, Hoeper MM, Gibbs JSR, et al. Pre-capillary, combined, and post-capillary pulmonary hypertension: a pathophysiological continuum? \u003cem\u003eJ Am Coll Cardiol. \u003c/em\u003e2016;68:368\u0026ndash;378.\u003c/li\u003e\n\u003cli\u003eAmerican Academy of Family Physicians. Pulmonary Hypertension \u003cem\u003e(\u003c/em\u003ehttps://familydoctor.org/condition/pulmonary-\u003cem\u003e \u003cbr\u003e hypertension/?adfree=true)\u003c/em\u003e. Accessed 6/2/2022.\u003c/li\u003e\n\u003cli\u003eBhogal S, Mukherjee D, Banerjee S, Islam AM, Daggubati R, Paul TK. Current trends and future perspectives in the treatment of pulmonary hypertension: WHO Group II-V \u003cem\u003e(https://pubmed.ncbi.nlm.nih.gov/29153390/)\u003c/em\u003e. \u003cem\u003eCurr Probl Cardiol\u003c/em\u003e. 2018 May;43(5):217-231. Accessed 6/2/2022\u003c/li\u003e\n\u003cli\u003eEuropean Pulmonary Hypertension Association. Classification and WHO Functional Class \u003cem\u003e(https://www.phaeurope.org/about-ph/classification-and-who-functional-class/)\u003c/em\u003e. Accessed 6/2/2022.\u003c/li\u003e\n\u003cli\u003ePulmonary Hypertension Association. Multiple pages \u003cem\u003e(\u003c/em\u003ehttps://phassociation.org/types-\u003cem\u003epulmonary-hypertension-groups/)\u003c/em\u003e. Accessed 6/2/2022\u003c/li\u003e\n\u003cli\u003eUnited Kingdom, National Health Service. Pulmonary Hypertension \u003cem\u003e(https://www.nhs.uk/conditions/pulmonary-hypertension/)\u003c/em\u003e. Accessed 6/2/2022\u003c/li\u003e\n\u003cli\u003eVoelkel N. F., Tuder R. M., Weir E. K. Pathophysiology of primary pulmonary hypertension. Primary pulmonary hypertension., L. J Rubin, S Rich, editors. Marcel Dekker, New York 1997; p. 83\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eTuder R. M., Cool C. D., Geraci M. W., Wang J., Abman S. H., Wright L., et al. Prostacyclin synthase expression is decreased in lungs from patients with severs pulmonary hypertension. Am J Respir Crit Care Med 1999; 159: 1925\u0026ndash;32\u003c/li\u003e\n\u003cli\u003eTuder R. M., Flook B. E., Voelkel N. F. Increased gene expression for VEGF and the VEGF receptors KDR/Flk and Flt in lungs exposed to acute or chronic hypoxia: modulation of gene expression by nitric oxide. J Clin Invest 1995; 95: 1798\u0026ndash;807\u003c/li\u003e\n\u003cli\u003eKhan MS, Memon MM, Amin E, et al. Use of balloon atrial septostomy in patients with advanced pulmonary arterial hypertension: A systematic review and meta-analysis \u003cem\u003e(https://pubmed.ncbi.nlm.nih.gov/30910639/)\u003c/em\u003e. \u003cem\u003eChest\u003c/em\u003e. 2019 Jul;156(1):53-63. Accessed 6/2/2022.\u003c/li\u003e\n\u003cli\u003eWijeratne DT, Lajkosz K, Brogly SB, et al. Increasing incidence and prevalence of World Health Organization Groups 1 to 4 pulmonary hypertension: A population-based cohort study in Ontario, Canada \u003cem\u003e(https://pubmed.ncbi.nlm.nih.gov/29444925/)\u003c/em\u003e. \u003cem\u003eCirc Cardiovasc Qual Outcomes\u003c/em\u003e. 2018 Feb;11(2):e003973. Accessed 6/2/2022.\u003c/li\u003e\n\u003cli\u003eUnited Kingdom, National Health Service. Pulmonary Hypertension \u003cem\u003e(https://www.nhs.uk/conditions/pulmonary-hypertension/)\u003c/em\u003e. Accessed \u003cbr\u003e 6/2/2022.\u003c/li\u003e\n\u003cli\u003eDumas J. P., Bardou M., Goirand F., Dumas M. Hypoxic pulmonary vasoconstriction. Gen Pharmacol 1999; 33: 289\u0026ndash;97\u003c/li\u003e\n\u003cli\u003eSweeney M., Yuan J. X. Hypoxic pulmonary vasoconstriction: role of voltage‐gated potassium channels. Respir Res 2000; 1: 40\u0026ndash;8\u003c/li\u003e\n\u003cli\u003eDeng Z., Morse J. H., Slager S. L., Cuervo N., Moore K. J., Venetos G., et al. Familial primary pulmonary hypertension (gene PPH1) is caused by mutations in the bone morphogenetic protein receptor‐II gene. Am J Hum Genet 2000; 67: 737\u0026ndash;44\u003c/li\u003e\n\u003cli\u003eRich S., Brundage B. H. High‐dose calcium channel‐blocking therapy for primary pulmonary hypertension: evidence for long‐term reduction in pulmonary arterial pressure and regression of right ventricular hypertrophy. Circulation 1987; 76: 135\u0026ndash;41\u003c/li\u003e\n\u003cli\u003eRaffy O., Azarian R., Brenot F., Parent F., Sitbon O., Petitpretz P., et al. Clinical significance of the pulmonary vasodilator response during short‐term infusion of prostacyclin in primary pulmonary hypertension. Circulation 1996; 93: 484\u0026ndash;8\u003c/li\u003e\n\u003cli\u003eRubin L. J., Mendoza J., Hood M., McGoon M., Barst R., Williams W. B., et al. Treatment of primary pulmonary hypertension with continuous intravenous prostacyclin (epoprostenol). Results of a randomized trial. Ann Intern Med 1990; 112: 485\u0026ndash;91\u003c/li\u003e\n\u003cli\u003eNootens M., Kaufmann E., Rich S. Short‐term effectiveness of nifedipine in secondary pulmonary hypertension. Am J Cardiol 1993; 71: 1475\u0026ndash;6\u003c/li\u003e\n\u003cli\u003eOleschewski H., Ghofrani H. A., Schmehl T., Winkleer J., Wilkens H., Hoper M. M., et al. Inhaled iloprost to treat severe pulmonary hypertension. An uncontrolled trial. German PPH Study Group. Ann Intern Med 2000; 132: 435\u0026ndash;43\u003c/li\u003e\n\u003cli\u003eBarst R. J., Langleben D., Frost A., Horn E. M., Oudiz R., Shapiro S., et al. Sitaxsentan therapy for pulmonary arterial hypertension. Am J Respir Crit Care Med 2004; 169: 441\u003c/li\u003e\n\u003cli\u003e\u003cspan dir=\"RTL\"\u003e24. \u003c/span\u003eSandoval J., Gaspar J., Pulido, Bautista E., Martinez‐Guerra M. L., Zeballos M., et al. Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension. A therapeutic alternative for patients non‐responsive to vasodilator treatment. J Am Coll Cardiol 1998; 32: 297\u0026ndash;304\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 8 is not available with this version\u003c/p\u003e\n\n\u003cp\u003eTables 1 to 7 and 9-10 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Syrian Private University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"pulmonary arterial pressure, Damascus ","lastPublishedDoi":"10.21203/rs.3.rs-4518319/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4518319/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePulmonary hypertension refers to high blood pressure in the pulmonary arteries that carry oxygen-poor blood from the heart to the lungs with a mean pulmonary artery pressure of ≥ 25 mm Hg.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive study was conducted on a sample of 246 patients attending Damascus Hospital. Their pulmonary pressure was measured, and several axes related to high pulmonary pressure were studied, including general medical antecedents and then studying the final diagnosis of the cause. A descriptive study of the sample was conducted and then an analytical study that served the research objectives.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA sample size of 248 patients was collected from the patients attending Damascus Hospital, of which the percentage of males was 51.6%, while the percentage of females was 48.4%.\u003c/p\u003e\n\u003cp\u003eThe age of the largest percentage of the sample, about 54.9%, was in the category (61 to 90 years).\u003c/p\u003e\n\u003cp\u003eThe percentage of smokers in the sample was 46.7%, about 2.8% of the sample, recorded that they were alcoholic.\u003c/p\u003e\n\u003cp\u003eThe majority of the sample recorded that they suffer from several conditions together, at a rate of 65.6%, about 70.3%, recorded no history of surgery.\u003c/p\u003e\n\u003cp\u003e75.2% of the sample recorded that they suffer from heart disorders, While 15.9% of the sample had disorders and problems in the respiratory system.\u003c/p\u003e\n\u003cp\u003eThe vast majority of the sample, 90.2%, had an elevated pulmonary pressure of more than 25 mmHg.\u003c/p\u003e\n\u003cp\u003ethe most common cause (final diagnosis) was heart failure, 35.3% .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e• Women were found to be at risk of having high pulmonary pressure with a risk factor of 1.5% more than men\u003c/p\u003e\n\u003cp\u003e• While the results of the one-way analysis of variance test showed that there is a significant effect and an important correlation between the patient’s age and high pulmonary pressure, as the risk increases with a risk factor of 0.43% as age increases.\u003c/p\u003e\n\u003cp\u003e• There is an important correlation and significant effect of smoking on the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003e• There is an important correlation and significant effect of alcohol consumption on the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003e• There is an important, statistically significant correlation to the presence of heart disease in the patient and high pulmonary pressure, as heart patients are at risk of having high pulmonary pressure with a risk factor of 1.12% more than patients without heart disease.\u003c/p\u003e\n\u003cp\u003e• Patients with respiratory problems and disorders are at risk of developing pulmonary hypertension, with a risk factor of 1.36%.\u003c/p\u003e\n\u003cp\u003e• There is an important, significant correlation between taking medications (antidepressants, appetite suppressants) and the degree of pulmonary hypertension.\u003c/p\u003e\n\u003cp\u003e• There is an important correlation between the final diagnosis and the cases reported as causes of pulmonary hypertension.\u003c/p\u003e","manuscriptTitle":"Study of the causes of high pulmonary arterial pressure at Damascus Hospital","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-05 17:54:41","doi":"10.21203/rs.3.rs-4518319/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"30aece51-b215-4a73-a763-a91c26ff4cd7","owner":[],"postedDate":"June 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":32837897,"name":"Cardiac \u0026 Cardiovascular Systems"}],"tags":[],"updatedAt":"2024-06-05T17:54:41+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-05 17:54:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4518319","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4518319","identity":"rs-4518319","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}