![Pulmonary Hypertension meeting](/content/dam/munichre/global/images/royalty-free/GettyImages-872235596.jpg/_jcr_content/renditions/cropped.3_to_1.jpg./cropped.3_to_1.jpg)
Case Clinic:
Pulmonary Hypertension
Munich Re’s medical experts respond to challenging underwriting scenarios
properties.trackTitle
properties.trackSubtitle
August 2024
This series presents individual medical cases that feature challenging conditions, uncommon diseases, or an unusual presentation of symptoms. Below, we summarize a case, explain our research and analysis, and suggest an underwriting recommendation. Munich Re’s team of global medical directors routinely conducts rigorous analyses of the latest medical advances so that primary insurers and society alike can benefit from evidence-informed risk assessments. It is our hope that exploring compelling cases will foster a greater understanding of medical research and awareness of new medical innovations and emerging risks while ultimately expanding insurability.
Case: Pulmonary Hypertension with Obstructive Sleep Apnea
Munich Re medical's response
What is pulmonary hypertension?
- Pulmonary hypertension (PH) refers to elevation of pressure in the pulmonary arteries. Etiology is typically divided into primary and secondary causes. Primary PH is rare and the prognosis is generally poor. Secondary PH is much more common, and presents as a complication of many different disorders, such as chronic lung disease (e.g., COPD), heart disease (e.g., left heart failure), or hypoxic pulmonary vasoconstriction (e.g., OSA).
How common is pulmonary hypertension, and what are some mortality and morbidity concerns?
- Primary pulmonary hypertension is rare, and the prognosis is poor.
- The prevalence of secondary pulmonary hypertension is difficult to assess because confirmatory testing is not always performed in patients with predisposing conditions. However, it is estimated that it may be present in up to 30% of those with moderate to severe OSA[1]
- Morbidity and mortality will vary, depending on the underlying cause of secondary PH. For example, drowsiness and accidents may complicate OSA, whereas right sided heart failure may develop if an underlying cause cannot be treated effectively, e.g., progressive pulmonary fibrosis.
- Pulmonary hypertension in the setting of OSA may be improved after successful treatment. In this instance, there is no extra mortality or morbidity.
Final recommendation
![John F. White III John F. White III](/content/dam/munichre/contentlounge/website-pieces/experts/John-White.png/_jcr_content/renditions/original./John-White.png)
![Gina Guzman Gina Guzman](/content/dam/munichre/global/images/staff-and-events-(data-protection-relevant)/Gina%20Guzman.jpg/_jcr_content/renditions/original./Gina%20Guzman.jpg)
![Bradley Heltemes Bradley Heltemes](/content/dam/munichre/global/images/staff-and-events-(data-protection-relevant)/Brad%20Heltemes.jpg/_jcr_content/renditions/original./Brad%20Heltemes.jpg)
![Tim Meagher Tim Meagher](/content/dam/munichre/global/images/staff-and-events-(data-protection-relevant)/Tim%20Meagher%202019.jpg/_jcr_content/renditions/original.image_file.120.120.file/Tim%20Meagher%202019.jpg)