Prevalence of pulmonary hypertension and associated factors among rheumatic heart disease patients having follow up at public referral hospitals in Bahir Dar, Ethiopia, 2023.

Abstract Background In developing countries evidences regarding pulmonary hypertension in rheumatic heart disease patients are lacking, despite being responsible for significant morbidity and mortality. As a result, identifying the factors that influence pulmonary hypertension is crucial to improve the quality of care. Objective To determine prevalence of pulmonary hypertension and its associated factors among rheumatic heart disease patients at the public hospitals of Bahir Dar city, 2023. Methods An institution based cross sectional study was conducted among Rheumatic heart disease patients who had follow up at the two public hospitals of Bahir Dar city form January 2022 to December 2023. It involved 310 patients selected by systematic random sampling technique. Pretested, structured, and interviewer-administered questionnaires were used to collect sociodemographic and diseases related parameters. Trans thoracic echocardiography by cardiologist was used to assess pulmonary hypertension. Data were entered using Epidata Manager version 4.6 and analyzed using SPSS version 27. Multivariate logistic regression analysis was used to identify determinants of glycemic control, considering with a p-value of < 0.05 as statically significant, with a 95% confidence interval. Results The mean sPAP of the participants were 50.2 mmHg [SD ± 25.0mmHg]. The prevalence of pulmonary hypertension among RHD patients were 56.5% (95% CI 50.9–61.9) from which 51.4% had severe pulmonary hypertension. Severe mitral valve stenosis (AOR 7.8, 95% CI 2.4–25.7), duration of illness ≥ 3 years (AOR 7.7, 95% CI 2.1–28.5), diuretics use (AOR 5.6, 95% CI 2.2–14.3,), valvular intervention (AOR 0.06, 95% CI 0.01 0.29) and LVEF ≥ 50% (AOR 0.14, 95% CI 0.02–0.81) were factors associated with pulmonary hypertension. Conclusions This study revealed more than half of the participants had pulmonary hypertension. And this was associated with having sever mitral valve stenosis, long duration of illness, diuretics use, valvular intervention and LVEF of ≥ 50%. Effective and tailored interventions are needed to mitigate these risk factors to improve pulmonary hypertension related comorbidities in rheumatic heart disease patients.