Medication treatment in pulmonary arterial hypertension with comorbidities - Which phenotypes and points to consider

Pneumologie. 2023 Nov;77(11):901-906. doi: 10.1055/a-2145-4726. Epub 2023 Nov 14.ABSTRACTWithin the last decade, the age at diagnosis of patients with pulmonary arterial hypertension has increased, which led to a change of the clinical phenoype being associated with more comorbidities. Cluster analyses of registry data have identified cardiac, cardio-pulmonary and classical phenotypes of pulmonary arterial hypertension.Subgroup analyses of randomised controlled trials and registry data indicate, that in patients with pulmonary arterial hypertension and cardiac comorbidities, especially the left-heart phenotype, a closely supervised combination treatment may be considered. The 4-strata model may be used for monitoring and risk stratification in these patients. Individual treatment decisions should be made in the pulmonary hypertension centre. Factors such as hemodynamics, age, phenotype, number and severity of comorbidities, therapy response, adverse reactions and the wish of the patient should be considered.Prospective, randomized studies to assess the efficacy and safety profile of pulmonary arterial hypertension treatments are desirable. Patients with a mainly pulmonary phenotype (smoking, diffusion capacity of the lung < 45 % and/or lung parenchymal changes) may have less benefit of oral medication.PMID:37963479 | DOI:10.1055/a-2145-4726

Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Ekkehard Gr ünig Michael Halank Claus Neurohr J ürgen Behr Katrin Milger-Kneidinger Julia Ronczka Mona Lichtblau Nicola Benjamin Tobias J Lange Silvia Ulrich Heinrike Wilkens Christian Groh é Dirk Skowasch Source Type: research