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Related Concept Videos

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure01:16

Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure

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Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
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Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors01:28

Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors

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Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
454
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

379
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
379
Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

499
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
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Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

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Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
363
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

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Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
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Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
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Treating pulmonary hypertension in the elderly.

Ioana A Campean1, Irene M Lang1

  • 1Department of Cardiology, Pulmonary Hypertension Unit, Medical University of Vienna , Vienna, Austria.

Expert Opinion on Pharmacotherapy
|April 2, 2020
PubMed
Summary

Treating older adults with pulmonary hypertension (PH) is challenging due to limited research. Current strategies, unlike those for younger patients, may lead to worse outcomes in geriatric populations with pulmonary arterial hypertension (PAH).

Keywords:
Elderlypulmonary hypertensionrisk assessmentsurvivaltreatment strategies

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Area of Science:

  • Geriatric Cardiology
  • Pulmonary Hypertension Research
  • Clinical Pharmacology

Background:

  • Limited clinical studies exist for pulmonary hypertension (PH) treatments in the growing elderly population.
  • Elderly patients with comorbidities are often excluded from clinical trials, restricting evidence for pulmonary arterial hypertension (PAH) drug approvals.
  • Geriatric populations present unique challenges in PH diagnosis and management.

Purpose of the Study:

  • To review the diagnosis and treatment of pulmonary hypertension (PH) in the elderly.
  • To address therapeutic challenges specific to elderly patients with pulmonary arterial hypertension (PAH).
  • To examine current demographic changes, clinical characteristics, diagnoses, and risk assessment in geriatric PAH patients.

Main Methods:

  • Literature review focused on PH in the elderly.
  • Analysis of demographic shifts, clinical presentations, and diagnostic approaches in geriatric PAH.
  • Evaluation of treatment strategies for PAH and chronic thromboembolic pulmonary hypertension (CTEPH) in older adults.
  • Focus on post-capillary conditions in the elderly.

Main Results:

  • Elderly patients with PH often present with more severe disease.
  • Aggressive treatment strategies like upfront combination therapy or early parenteral prostacyclins are underutilized in geriatric PAH patients.
  • Current treatment approaches may not align with the "hit hard and early" concept often applied to younger patients.

Conclusions:

  • Despite disease severity, less aggressive treatment strategies are employed in elderly patients with PAH.
  • Underutilization of intensified treatment regimens in older adults may contribute to poorer outcomes.
  • Further research and tailored treatment guidelines are needed for geriatric PH patients.