Effects of age on pulmonary artery systolic pressure at rest and during exercise in normal adults

Aims The aim of this study was to explore the range of pulmonary artery systolic pressure (PASP) at rest and with exercise in healthy individuals of various ages, as most studies assumed PASP > 35 mmHg with exercise as the upper limits of normal. Methods and results Seventy healthy volunteers, with a good continuous wave Doppler tricuspid regurgitation signal at rest, underwent quantitative Doppler echocardiographic measurements at rest and during semi-supine exercise test. Pulmonary artery systolic pressure was estimated at rest, at low level (25 W), and at peak exercise using four times tricuspid valve regurgitation velocity squared adding a right atrial pressure of 5 mmHg. During exercise, PASP increased from rest (27 +/- 4 mmHg) to peak (51 +/- 9 mmHg). None of the individuals reached a PASP >= 60 mmHg at 25 W. Pulmonary artery systolic pressure at peak was higher in individuals >= 60 years old compared with those from 20 to 59 years old (56 +/- 9 vs. 49 +/- 7 mmHg, P = 0.02). Pulmonary artery systolic pressure at peak exercise >= 60 mmHg was found in 36% of the individuals aged from 60 to 70 and in 50% after 70. Age, LV mass, and PASP at rest were independent predictors of PASP at peak exercise. Conclusion Pulmonary artery systolic pressure at peak exercise can reach values >= 60 mmHg in many healthy individuals older than 60 with good exercise capacity. However, high levels of PASP > 60 mmHg for low level of exercise should be considered abnormal.