Red Cell Distribution Width May Be a Biomarker for Early Pulmonary Hypertension in SSc

Red cell distribution width may help detect early incident PH in patients who are at high risk for PH development.

A new study found that red cell distribution width (RDW) is higher in patients with pulmonary hypertension (PH) and at-risk patients with systemic sclerosis (SSc) compared with healthy individuals. Findings from this study, which suggest that RDW may be a potential biomarker for detecting incident PH in its earlier stages, were published in Respiratory Medicine.

Researchers performed a retrospective cross-sectional analysis of patients who were observed at a PH specialty center over a 1-year period. PH was defined as a mean pulmonary artery pressure ≥25 mmHg at rest during right heart catheterization. Patients with PH (n=181) and patients with SSc at risk for PH development (n=52) were compared. A total of 100 non-diseased controls were also included for comparison.  The groups were compared in terms of their relevant baseline characteristics, and researchers also made comparisons across World Health Organization (WHO) PH groups 1-4.

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The overall value of RDW was higher in patients with PH compared with the at-risk patients with SSc and matched controls (15.9±2.8 vs 14.8±2.8 vs 14.2±1.1%, respectively; P <.0001).

Patients with PH in the SSc cohort (n=21) had higher RDW values vs the 15 patients without PH in the same cohort (16.0±2.2 vs 14.4±1.9%, respectively; P =.03). For discriminating between patients with SSc with and without PH, the optimal cut-point was 13.25% (100% sensitivity and 40% specificity).

No differences were observed across WHO PH groups with regard to RDW values (P =.50). Specifically, in the PH cohort there was no RDW difference between patients of functional class 1 or (15.6±2.7% [n=81]) vs functional class 3 or 4 (16.4±3.0% [n=88]; P =.10).

Study limitations include its retrospective design, the small size of the subgroups, and the inclusion of patients from a single center.

The researchers commented that the ease of obtaining RDW “in SSc patients may help to detect PH at earlier stages, leading to better outcomes and better quality of life.”


Petrauskas LA, Saketkoo LA, Kazecki T, et al. Use of red cell distribution width in a population at high risk for pulmonary hypertension. Respir Med. 2019;150:131-135.

This article originally appeared on The Cardiology Advisor