Secondary pulmonary arterial hypertension: to treat or not to treat?

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Abstract

Purpose of review The purpose of this review is to review recent literature related to mechanisms and treatment options for 'secondary' (i.e., WHO Groups 3 and 5) pulmonary arterial hypertension (PAH). Recent findings Published randomized controlled trials, in general, do not support the use of approved therapies for 'primary' (i.e., WHO Group 1) PAH patients in patients with Group 3 PAH because of the small numbers of patients and inconsistent benefit. Therefore, we currently recommend against the use of these medications for Group 3 PAH. Similarly, there is limited evidence supporting the use of Group 1 PAH medications in Group 5 patients. In most patients with Group 5 PAH, treatment should be directed to the underlying disease. Summary The utility of PAH-specific therapy in WHO Group 3 PAH is unclear because of the small numbers of patients evaluated and inconsistent beneficial effects observed. There is limited evidence supporting the use of PAH medications in Group 5 patients, and they may be harmful in some cases.

Original languageEnglish (US)
Pages (from-to)324-329
Number of pages6
JournalCurrent Opinion in Organ Transplantation
Volume23
Issue number3
DOIs
StatePublished - Jun 1 2018

Keywords

  • chronic obstructive pulmonary disease
  • diffuse parenchymal lung disease
  • idiopathic pulmonary fibrosis
  • pulmonary arterial hypertension
  • sarcoidosis

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