A global perspective on the epidemiology of pulmonary hypertension.

The epidemiology of pulmonary hypertension (PH) is not fully determined worldwide but is believed to vary in different regions of the world, with differences determined by genetic, geographic, environmental, and socioeconomic factors, as well as sex-related practices and inequities in access to health care. This article reviews the global epidemiology of PH, with emphasis on the prevalence, causes, forms, and underlying factors in the developing world. Left ventricular heart disease is the most common cause worldwide, but the main contributors in developing countries are chronic infectious diseases, hypertensive heart disease, cardiomyopathy, and rheumatic heart disease. Despite data suggesting a high prevalence in Sub-Saharan Africa, the available literature is very limited. International registries like the Pan African Pulmonary Hypertension Cohort are essential to provide information about the causes, comorbidities, and diagnostic classification, therapeutic management, and the natural course of PH worldwide. Moreover, there is a need to track diagnostic and management practices and challenges to identify the gaps and gradients between different regions of the world. The information gained will pinpoint areas for improvement, aiming at bridging the current divide between low-income and high-income countries.