# Pulmonary arterial hypertension in Latin America. The age and comorbidity paradox

## TL;DR

This paper reviews how pulmonary arterial hypertension (PAH) is different in Latin America compared to other regions, focusing on age and comorbidities.

## Contribution

The paper highlights a potential 'age and comorbidity paradox' in PAH epidemiology specific to Latin America.

## Key findings

- Latin American PAH patients are generally younger and have fewer comorbidities compared to global trends.
- Recent global registries show older PAH patients with more comorbidities, but these are underrepresented in clinical trials.
- The paper questions whether Latin America has a distinct PAH phenotype or is lagging in epidemiological changes.

## Abstract

Pulmonary arterial hypertension (PAH) has been classically described as a disease in young adults, predominantly females with no comorbidities. However, in recent registries, the epidemiology has changed to older patients with comorbidities such as obesity, diabetes, systemic hypertension, and coronary heart disease. Nevertheless, there is not enough inclusion of these patients in clinical trials. In contrast, in Latin America, registries have shown that PAH patients are younger and have fewer comorbidities, which raises the question of whether Latin American patients present a different phenotype or if we are lagging behind developed countries and whether we will experience a change in epidemiology in the next couple of years. We analyzed these trends in this review.