Pulmonary Hypertension in COPD: Prevalence, Impact on Exercise Capacity, and Quality of Life
Keywords:
6 min walk test, chronic obstructive pulmonary disease, pulmonary hypertension, St George Respiratory Questionnaire, two‑dimensional echocardiographyAbstract
Background: Pulmonary hypertension (PH) is a significant complication in chronic obstructive pulmonary disease (COPD), especially in advanced stages, impacting patients' exercise capacity and quality of life. This study aimed to investigate the prevalence of PH in COPD patients, analyze its correlation with disease severity, and assess its effects on exercise capacity and quality of life.
Methods: A cross-sectional observational study was conducted on 100 COPD patients. Pulmonary hypertension was diagnosed using 2D-echocardiography. Patients were categorized according to their GOLD stage, and PH severity was classified as mild, moderate, or severe. Exercise capacity was measured using the 6-minute walk test (6MWT), and quality of life was assessed with the St. George’s Respiratory Questionnaire (SGRQ).
Results: PH was prevalent in 40% of the COPD patients, with the highest occurrence in the 61–70 year age group (50%). Prevalence increased with COPD severity, affecting 20% of patients in GOLD Stage I and rising to 80% in GOLD Stage IV. Most cases of PH were mild (26.8%), with fewer cases of moderate (18%) and severe PH (3.09%). There was a strong inverse correlation between pulmonary artery pressure (PAP) and 6MWT distance (R = -0.98, p < 0.001), with each 1 mmHg increase in PAP reducing walking distance by 4.95 meters. A positive correlation was observed between PAP and SGRQ scores (R = 0.96, p < 0.001), indicating a marked deterioration in quality of life with increased PH severity.
Conclusion: Pulmonary hypertension is highly prevalent among COPD patients, particularly in advanced stages of the disease. The strong correlations between PH, reduced exercise capacity, and poor quality of life underscore the importance of early detection and management of PH in COPD patients to mitigate its impact on daily functioning and overall prognosis. Early intervention strategies, including pulmonary rehabilitation and regular monitoring of PAP, should be considered essential components of COPD management.
