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Sildenafil for pulmonary hypertension.

Audrey J Lee1, Teresa B Chiao, Mildred P Tsang

  • 1Thomas J Long School of Pharmacy, University of the Pacific, Veterans Affairs Medical Center, San Francisco, CA, USA. audrey.lee@med.va.gov

The Annals of Pharmacotherapy
|April 14, 2005
PubMed
Summary

Sildenafil shows promise in treating pulmonary hypertension, improving exercise tolerance and reducing pulmonary vascular resistance. Further research is needed to confirm its efficacy and optimal use in patient care.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Pharmacology

Background:

  • Pulmonary hypertension (PH) presents a significant therapeutic challenge.
  • Sildenafil is being investigated for its potential in managing PH.

Purpose of the Study:

  • To evaluate the efficacy of sildenafil in the treatment of pulmonary hypertension.

Main Methods:

  • A comprehensive literature search was conducted using MEDLINE, Cochrane Library, and International Pharmaceutical Abstracts.
  • Included studies involved more than five adult patients and were published in English.
  • Eight hemodynamic studies and 12 clinical trials (retrospective, double-blind, open-label) were reviewed.

Main Results:

  • Sildenafil demonstrated a reduction in pulmonary arterial hypertension and pulmonary vascular resistance, with a trend towards increased cardiac output.

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  • Its pulmonary vasoreactivity was comparable to nitric oxide and at least as effective as iloprost or epoprostenol.
  • Combination therapy showed enhanced and prolonged pulmonary vascular effects. Sildenafil was generally well-tolerated.

    • Conclusions:

    • Sildenafil is a promising and well-tolerated option for managing pulmonary hypertension.
    • Further robust clinical trials are necessary to solidify its role in PH treatment.