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Current Cardiology Reports

, 21:141 | Cite as

Pulmonary Arterial Hypertension: a Pharmacotherapeutic Update

  • James C. CoonsEmail author
  • Kristen Pogue
  • Andrew R. Kolodziej
  • Glenn A. Hirsch
  • Marjorie Patricia George
Heart Failure (HJ Eisen, Section Editor)
  • 178 Downloads
Part of the following topical collections:
  1. Topical Collection on Heart Failure

Abstract

Purpose of Review

Pulmonary arterial hypertension (PAH) leads to progressive increases in pulmonary vascular resistance (PVR), right heart failure, and death if left untreated. This review will summarize and discuss recent updates in the classification and management of patients with PAH.

Recent Findings

PAH requires careful hemodynamic assessment and is defined by a mean pulmonary artery pressure > 20 mmHg with normal left-sided filling pressures and a PVR ≥ 3 Wood units. Most patients with PAH require targeted pharmacotherapy based on multiparametric risk stratification. Significant improvements in clinical outcome have been realized through the approval of 14 unique pharmacotherapeutic options.

Summary

The latest clinical recommendations provide the updated hemodynamic definition and clinical classification as well as evidence-based treatment recommendations. An important change is the focus on initial upfront combination therapy for most patients with PAH. Structured follow-up and escalation of treatment for those not achieving low-risk status is paramount.

Keywords

Pulmonary hypertension Pulmonary arterial hypertension WHO group 1 pulmonary hypertension Chronic thromboembolic pulmonary hypertension (CTEPH) 

Notes

Compliance with Ethical Standards

Conflict of Interest

James C. Coons reports a grant from United Therapeutics.

Kristen Pogue reports no conflicts of interest.

Andrew R. Kolodziej reports no conflicts of interest.

Glenn A. Hirsch reports no conflicts of interest.

Marjorie Patricia George reports a grant from Actelion, and personal fees from Actelion, Gilead, Bayer.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • James C. Coons
    • 1
    Email author
  • Kristen Pogue
    • 2
  • Andrew R. Kolodziej
    • 3
  • Glenn A. Hirsch
    • 4
  • Marjorie Patricia George
    • 5
  1. 1.Department of Pharmacy and Therapeutics, University of Pittsburgh School of PharmacyUPMC Presbyterian HospitalPittsburghUSA
  2. 2.University of MichiganAnn ArborUSA
  3. 3.Gill Heart InstituteUniversity of KentuckyLexingtonUSA
  4. 4.Division of Cardiology, Department of MedicineNational Jewish HealthDenverUSA
  5. 5.Division of Pulmonary, Critical Care & Sleep Medicine, Department of MedicineNational Jewish HealthDenverUSA

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