Treating pulmonary hypertension in the elderly.

Treating pulmonary hypertension in the elderly. Expert Opin Pharmacother. 2020 Mar 31;:1-7 Authors: Campean IA, Lang IM Abstract Introduction: Despite an increasingly older pulmonary hypertension (PH) population, data on PH treatments in these patients are limited because there exist no clinical studies dedicated to geriatric groups. Furthermore, elderly patients with comorbidities have been systematically excluded from clinical trials, limiting the evidence base for drugs approved for pulmonary arterial hypertension (PAH).Areas covered: This review is focused on the diagnosis and treatment of pulmonary hypertension (PH) in the elderly, which is a hot topic today. Areas covered by the authors include current changes in demographics, clinical characteristics, diagnoses, and risk assessment in the geriatric PAH population. A central part of this review is dedicated to the therapeutic challenges in elderly patients with PAH. The literature search is focused on sorting out post-capillary conditions in the elderly, and on current treatment strategies for PAH and for chronic thromboembolic pulmonary hypertension (CTEPH).Expert opinion: Current data indicate that despite more severe disease in elderly patients, the concept of hit hard and early is less used. For example, double upfront oral combination, a common strategy for younger patients, or early parenteral prostacyclins, are less used in the elderly, purporting worse outcomes for these patients. P...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

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Authors: Gocho K, Kimura T, Hamanaka N, Ishii T, Takemura T, Shimizu K Abstract In the 2013 updated classification of the American Thoracic Society/European Respiratory Society, airway-centered interstitial fibrosis (ACIF) is included as a bronchiolocentric pattern of interstitial pneumonia (IP) among idiopathic IPs. We encountered a case of severe pulmonary hypertension (PH) with chronic IP. The patient initially presented with shortness of breath and often lost consciousness due to PH, and seven years after his first visit, he ultimately died. An autopsy revealed ACIF and usual IP. In particular, the ACIF compri...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
ConclusionsFrom the results of the CEPH model dogs, autonomic dysfunction was shown to occur in PH dogs. In addition, the administration of 1  mg/kg of sildenafil to CEPH model dogs may improve autonomic dysfunction.
Source: Veterinary Research Communications - Category: Veterinary Research Source Type: research
In patients with significant tricuspid regurgitation (TR) the conventional markers for the assessment of right ventricular (RV) systolic function may be less accurate. Tricuspid annular plane systolic excursion (TAPSE) indexed to systolic pulmonary artery pressure (SPAP) (TAPSE/SPAP) may be prognostically useful in pulmonary hypertension and left ventricular dysfunction. Our aim was to explore its use in patients with moderate or severe TR.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
There are limited published data defining survival and treatment response in patients with mild lung disease and/or reduced gas transfer who fulfil diagnostic criteria for idiopathic pulmonary arterial hypertension (IPAH). Patients diagnosed with IPAH between 2001 and 2019 were identified in the ASPIRE (Assessing the Spectrum of Pulmonary Hypertension Identified at a Referral Centre) registry. Using prespecified criteria based on computed tomography (CT) imaging and spirometry, patients with a diagnosis of IPAH and no lung disease were termed IPAHno-LD (n=303), and those with minor/mild emphysema or fibrosis were described...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary vascular disease Original Articles: Pulmonary hypertension Source Type: research
Pulmonary hypertension (PH) in the context of chronic lung disease (i.e. group 3 PH) is an ongoing and unresolved challenge. Looking specifically into precapillary PH, it is evident that its presence in chronic lung disease is associated with increased dyspnoea, reduced exercise tolerance, worsened oxygenation, low diffusion capacity of the lung for carbon monoxide (DLCO) and dismal prognosis. Noteably, pulmonary vascular disease is known to negatively impact clinical outcomes in chronic lung disease, even though the definition of precapillary PH may not yet be fulfilled [1]. Vice versa, the presence of mild or subclinical...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research
Publication date: August 2020Source: IJC Heart &Vasculature, Volume 29Author(s): M.C.J. van Thor, R.J. Snijder, J.C. Kelder, J.J. Mager, M.C. Post
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
Obesity and pulmonary hypertension (PH) share common characteristics, such as augmented inflammation and oxidative stress. However, the exact role of obesity in the pathology of PH is largely uninvestigated. T...
Source: Respiratory Research - Category: Respiratory Medicine Authors: Tags: Research Source Type: research
AbstractObjectivesThe primary objective of the study is to assess the safety of a single intravenous infusion of Mesenchymal Stromal Cells (MSCs) in patients with Acute Respiratory Distress Syndrome (ARDS) due to COVID-19. Secondary objectives are to determine the effects of MSCs on important clinical outcomes, as described below.Trial designREALIST COVID 19 is a randomised, placebo-controlled, triple blinded trial.ParticipantsThe study will be conducted in Intensive Care Units in hospitals across the United Kingdom. Patients with moderate to severe ARDS as defined by the Berlin definition, receiving invasive mechanical ve...
Source: Trials - Category: Research Source Type: clinical trials
Am J Perinatol DOI: 10.1055/s-0040-1712999 Objective Despite its increasing use in neonates, the literature on the use of vasopressin (VP) in neonates is limited. The aim of this study is to evaluate the systemic and pulmonary effects of VP in neonates and to assess its safety among them. Study Design This retrospective study enrolled all neonates in two level III neonatal intensive care units in Winnipeg, Manitoba, who had received VP therapy between 2011 and 2016. Infants with congenital malformations/chromosomal disorders were excluded. The changes in cardiovascular and pulmonary parameters were collecte...
Source: American Journal of Perinatology - Category: Perinatology & Neonatology Authors: Tags: Original Article Source Type: research
Tibetans have adapted to the chronic hypoxia of high altitude and display a distinctive suite of physiologic adaptations, including augmented hypoxic ventilatory response and resistance to pulmonary hypertension. Genome-wide studies have consistently identified compelling genetic signatures of natural selection in two genes of the Hypoxia Inducible Factor pathway, PHD2 and...
Source: Proceedings of the National Academy of Sciences - Category: Science Authors: Tags: Biological Sciences Source Type: research
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