APPETITE-SUPPRESSANTS AND PRIMARY PULMONARY-HYPERTENSION IN THE UNITED-KINGDOM

Objective-Amphetamine-like appetite suppressants, particularly fenflur amines, have been implicated in the aetiology of primary pulmonary hyp ertension. At one specialist centre in France 20% of patients with pri mary pulmonary hypertension had been exposed to fenfluramine. The prev alence of primary pulmonary hypertension associated with fenfluramines and other appetite suppressants in the United Kingdom is unknown. Thi s study was performed to measure prior exposure to appetite suppressan ts in patients with primary pulmonary hypertension. Setting-Heart lung transplantation centres in England. Patients-United Kingdom residents with proven primary pulmonary hypertension referred for consideration of heart lung transplantation. Methods-Case surveillance study, obtai ning data from the hospital and general practitioner's notes and direc tly from the patients or their relatives. Results-55 patients were ide ntified. Drug histories were available from hospital records in all pa tients, from the general practitioner's notes in 51, and from the pati ents or relatives in 44. Of these, 3 female patients had been exposed to appetite suppressants (2 fenfluramine, 1 diethylpropion): 2 have si nce died. In each case exposure was brief and apparently predated the development of symptoms by several years. Conclusions-Exposure of pati ents with severe primary pulmonary hypertension to fenfluramine and et her appetite suppressants is uncommon in the United Kingdom unlike in France, where most of the cases associating primary pulmonary hyperten sion with fenfluramine use have originated. This may reflect more cons ervative prescribing of these agents in the United Kingdom.