E-Science Station

Modern science and medicine have dramatically improved individual health and significantly extend people lifespan. Despite significant improvement in disease management with physiologically approach, psycho social approach has obtained relatively less attention. In developed countries, pulmonary hypertension conferred an enormous burden due to associated higher mortality despite improvement in disease management and care. Recent studies have explored the link between cardiovascular and suicide attempt. To our knowledge, currently there is no investigation concerning the incidence and detailed characteristics of suicide attempt in individuals affected by pulmonary hypertension. To provide more insights in this field, this study aims to investigate retrospectively the incidence of new onset suicide attempt among subjects with pulmonary hypertension, with a physiologic hypothesis, in a large cohort of two equally distributed groups using the Taiwan National Heath Research Institute (NHI) database.

7727 pulmonary hypertension patients and comparison subjects were enrolled in this study. Cox’s proportional hazard models were used to evaluate the hazard ratio (HR)for exploring the association of pulmonary hypertension with suicide attempt and mortality of suicide. Multivariate cox proportional hazard model was used to calculate the adjusted HRs after adjustment for variables which associated with suicide attempt in uni variate models.

Among patients younger than 65 years old, compared to comparison cohort, pulmonary hypertension patients had significant higher adjusted HRs (95% CI) for suicide attempt of 2.47 (2.05, 2.98). Among patients older than 65 years old, compared to comparison cohort, pulmonary hypertension patients also had significant higher adjusted HRs (95% CI) for suicide attempt of 1.39 (1.20, 1.62). There were significant interactions between age and pulmonary hypertension (P<0.001). Among male, compared to comparison cohort, pulmonary hypertension patients had significant higher adjusted HRs (95% CI) for suicide attempt of 1.98 (1.63,2.42). There were significant interactions between gender and pulmonary hypertension (P<0.001). Among patients with anyone of commodities, compared to comparison cohort, pulmonary hypertension patients had significant higher adjusted HRs (95% CI) for suicide attempt of 6.22 (5.07, 7.63). There were significant interactions between with/without anyone of comorbidities and pulmonary hypertension (P<0.001).

Pulmonary hypertension is associated with higher risk of suicide attempts. The risk appears to be increased to the highest level in the age group between ≤ 64 years, male gender low income, higher urbanization level, and no comorbidity.