Ranard LS, El Mallah W, Awerbach JD, et al. - Using a prospectively gathered database of atrial septal defect (ASD) closures, researchers determined how patient survival is influenced by pulmonary hypertension (PH) at time of ASD device closure. By age above and below the cohort median (48 years), they stratified the patients. PH was present in 21.1% of patients and was more common among the older cohort. More medical comorbidities such as diabetes, hyperlipidemia and systemic hypertension were seen in older patients vs younger patients. Findings revealed a common prevalence of PH in adults with unrepaired ASDs. PH seemed to be not associated with defect size. A worsened clinical outcome was strongly predicted by PH in older adults and its persistence closure. To alleviate this risk, additional risk evaluation and advanced medical therapies may be beneficial for these patients. Survival was not influenced by PH in patients ≤ 48 years, but it was linked to a five-fold higher risk of death in patients > 48 years.