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Frailty in Pulmonary Arterial Hypertension: A Cohort Study
Gordon J Farley1, Melanie Prakash2, Harold I Palevsky2
1Department of Internal Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
Annals of the American Thoracic Society
|July 16, 2026
Summary
Frailty is common in pulmonary arterial hypertension (PAH) patients, linked to older age, more body fat, worse quality of life, and higher mortality risk. This condition impacts survival and needs further study in PAH.
Area of Science:
- Cardiology
- Gerontology
- Pulmonology
Background:
- Frailty is a significant predictor of morbidity and mortality.
- Pulmonary arterial hypertension (PAH) patients face a high risk of frailty, yet it remains understudied in this population.
Purpose of the Study:
- To identify risk factors for frailty in PAH patients.
- To determine the impact of frailty on quality of life (QoL) and mortality within the PAH cohort.
Main Methods:
- A prospective, single-center cohort study included 80 PAH patients.
- Frailty was assessed using the Short Physical Performance Battery (SPPB) score (≤9 indicating frailty or pre-frailty) at baseline, 6, and 12 months.
- Demographic, metabolic, hemodynamic, and QoL data were collected.
Main Results:
- Nearly half (49%) of the PAH patients were identified as frail.
- Frail patients were older, exhibited higher mortality risk, and had increased measures of body fat (fat mass index, android-to-gynoid ratio, visceral adipose tissue area).
- Higher IL-6 levels correlated with frailty, and frail patients reported worse QoL and reduced transplant-free survival.
Conclusions:
- Frailty is highly prevalent in PAH patients, associated with advanced age, increased body fat, and poorer health outcomes.
- Frailty significantly worsens quality of life and survival in individuals with pulmonary arterial hypertension.
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