Although mild pulmonary hypertension is known to be associated with increased mortality, its impact on premature mortality is largely unknown.

We studied the distribution of estimated right ventricular systolic pressure (eRVSP) among a total of 154 956 adults with no evidence of left heart disease investigated with echocardiography. We then examined individually linked mortality, premature mortality and associated life-years lost (LYL) according to eRVSP levels.

The cohort comprised 70 826 men and 84 130 women (aged 61.3±17.7 and 61.4±18.4 years, respectively). Overall, 85 173 (55.0%), 49 276 (31.8%), 13 060 (8.4%) and 7447 (4.8%) cases had eRVSP levels indicative of no (<30.0 mmHg), mild (30.0–39.9 mmHg), moderate (40.0–49.9 mmHg) or severe (≥50.0 mmHg) pulmonary hypertension, respectively. During a median (interquartile range) 5.7 (3.2–8.9) years of follow-up, 38 456/154 986 (24.8%) individuals died. Compared with eRVSP <30.0 mmHg, age and sex-adjusted hazard ratios for all-cause and cardiovascular-related mortality were 1.90 (95% CI 1.84–1.96) and 1.85 (95% CI 1.74–1.97), respectively, for eRVSP 35.0–39.9 mmHg. Overall, 6256 (54%) men and 7524 (55%) women died prematurely. As a proportion of all deaths, premature mortality rose from 46.7% to 79.2% among those with eRVSP <30.0 versus ≥60.0 mmHg with a mean of 5.1–11.4 LYL each time. However, due to more individuals affected overall, eRVSP 30.0–39.9 mmHg accounted for 58% and 53% of total LYL among men (40 606/70 019 LYL) and women (47 333/88 568 LYL), respectively.

These data confirm that elevated eRVSP levels indicative of mild pulmonary hypertension are associated with increased risk of death. Moreover, this results in a substantive component of premature mortality/LYL that requires more proactive clinical surveillance and management.

虽然已知轻度肺动脉高压与死亡率增加有关，但其对过早死亡的影响在很大程度上是未知的。

我们研究了估计的右心室收缩压 (eRVSP) 在总共 154 956 名成人中的分布，这些成人通过超声心动图检查没有左心疾病的证据。然后，我们根据 eRVSP 水平检查了单独相关的死亡率、过早死亡率和相关的生命年损失 (LYL)。

该队列包括 70 826 名男性和 84 130 名女性（年龄分别为 61.3±17.7 和 61.4±18.4 岁）。总体而言，85 173 (55.0%)、49 276 (31.8%)、13 060 (8.4%) 和 7447 (4.8%) 病例的 eRVSP 水平表明无（<30.0 mmHg）、轻度（30.0-39.9 mmHg）、中度(40.0–49.9 mmHg) 或严重 (≥50.0 mmHg) 肺动脉高压。在中位（四分位距）5.7（3.2-8.9）年的随访中，38 456/154 986（24.8%）人死亡。与 eRVSP <30.0 mmHg 相比，在 eRVSP 35.0– 39.9 毫米汞柱。总体而言，6256 (54%) 名男性和 7524 (55%) 名女性过早死亡。作为所有死亡的比例，在 eRVSP <30.0 的人群中，过早死亡率从 46.7% 上升到 79.2%与≥60.0 mmHg 相比，每次平均 5.1-11.4 LYL。然而，由于总体受影响的个体更多，eRVSP 30.0-39.9 mmHg 分别占男性 (40 606/70 019 LYL) 和女性 (47 333/88 568 LYL) 总 LYL 的 58% 和 53%。

这些数据证实，表明轻度肺动脉高压的 eRVSP 水平升高与死亡风险增加有关。此外，这会导致过早死亡/LYL 的实质性组成部分，需要更积极主动的临床监测和管理。