{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T14:39:11Z","timestamp":1769179151811,"version":"3.49.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,4,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The determinants of pulmonary artery systolic pressure (\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              ) are not fully understood. It is unknown whether racial differences in\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              exist or if other population characteristics are associated with pulmonary pressure in humans. We examined echocardiographically estimated\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              in the Coronary Artery Risk Development in Young Adults (\n              <jats:styled-content style=\"fixed-case\">CARDIA<\/jats:styled-content>\n              ) study, a middle\u2010aged, biracial community\u2010based cohort.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              At the\n              <jats:styled-content style=\"fixed-case\">CARDIA<\/jats:styled-content>\n              year\u201025 examination, 3469 participants underwent echocardiography, including measurement of tricuspid regurgitant jet velocity to estimate\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              . Clinical features, laboratory values, pulmonary function tests, and measurement of adipose depot volume were analyzed for association with\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              .\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              was estimated in 1311 individuals (61% female, 51% white). Older age, higher blood pressure, and higher body mass index were associated with higher\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              . Black race was associated with higher\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              after adjustment for demographics and left and right ventricular function (\u03b2 0.94, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              0.24\u20101.64;\n              <jats:italic>P<\/jats:italic>\n              =0.009), but this association was no longer significant after further adjustment for lung volume (\u03b2 0.42, 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              \u22120.68 to 0.96;\n              <jats:italic>P<\/jats:italic>\n              =0.74). Insulin resistance, inflammation (C\u2010reactive protein and interleukin\u20106), and visceral adipose volume were independently associated with higher\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              after adjustment for relevant covariates.\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              rose with worsening diastolic function (ratio of early transmitral Doppler velocity to average mitral annular tissue Doppler velocity [E\/e\u2032] and left atrial volume index).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In a large biracial cohort of middle\u2010aged adults, we identified associations among black race, insulin resistance, and diastolic dysfunction with higher echocardiographically estimated\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              . Further studies are needed to examine racial differences in\n              <jats:styled-content style=\"fixed-case\">PASP<\/jats:styled-content>\n              and whether insulin resistance directly contributes to pulmonary vascular disease in humans.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.005111","type":"journal-article","created":{"date-parts":[[2017,3,31]],"date-time":"2017-03-31T00:10:48Z","timestamp":1490919048000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Echocardiographic Pulmonary Artery Systolic Pressure in the Coronary Artery Risk Development in Young Adults (CARDIA) Study: Associations With Race and Metabolic Dysregulation"],"prefix":"10.1161","volume":"6","author":[{"given":"Evan L.","family":"Brittain","sequence":"first","affiliation":[{"name":"Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, TN"},{"name":"Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chike","family":"Nwabuo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Johns Hopkins Hospital, Baltimore, MD"},{"name":"Harvard Medical School, Mount Auburn Hospital, Cambridge, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, TN"},{"name":"Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna R.","family":"Hemnes","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrique T.","family":"Moreira","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Johns Hopkins Hospital, Baltimore, MD"},{"name":"Division of Cardiology, University of S\u00e3o Paulo, Ribeir\u00e3o Preto, S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrique Doria","family":"De Vasconcellos","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Johns Hopkins Hospital, Baltimore, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James G.","family":"Terry","sequence":"additional","affiliation":[{"name":"Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Carr","sequence":"additional","affiliation":[{"name":"Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joao A. 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