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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,...
569
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...
428
Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

552
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...
552
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

421
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...
421
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists01:23

Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists

447
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...
447
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors01:28

Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors

542
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...
542

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Related Experiment Video

Updated: Jan 11, 2026

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
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Comparing Pulmonary Arterial Hypertension Care in Urban and Rural Settings: Treatment Patterns and Risk Trajectories.

Amrit K Deol1, Dominique Ingram1, Elizabeth Dranow1

  • 1Division of Cardiovascular Medicine University of Utah Salt Lake City Utah USA.

Pulmonary Circulation
|November 13, 2025
PubMed
Summary

Pulmonary arterial hypertension (PAH) care shows similar initial outcomes for urban and rural patients. However, rural patients on triple therapy were more likely to receive inhaled treprostinil, and urban patients improved their risk category over time.

Keywords:
expert carehealth systemspulmonary arterial hypertensionretrospective

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Area of Science:

  • Cardiology
  • Pulmonology
  • Health Services Research

Background:

  • Pulmonary arterial hypertension (PAH) is a severe condition affecting mortality and quality of life.
  • Disparities in specialized care access between urban and rural populations may impact PAH patient outcomes.
  • Understanding these differences is crucial for equitable disease management.

Purpose of the Study:

  • To compare the clinical course and treatment patterns of urban versus rural PAH patients.
  • To identify potential differences in care delivery and outcomes based on geographic location.
  • To inform strategies for improving PAH management in diverse settings.

Main Methods:

  • Prospective enrollment of 263 adult WHO Group I PAH patients into a registry at a single comprehensive care center.
  • Categorization of patients into urban or rural groups based on residential address.
  • Comparison of baseline characteristics, diagnostics, treatments, 6-minute walk distance (6MWD), right ventricular function, hemodynamics, NT-proBNP, and REVEAL Lite 2 scores.

Main Results:

  • No significant differences in baseline characteristics, functional status (6MWD), or hemodynamic parameters were observed between urban and rural patients.
  • Rural patients receiving triple therapy were more likely to be prescribed inhaled treprostinil (p=0.03).
  • Urban patients demonstrated a significant improvement in REVEAL risk category over time (p=0.007), unlike rural patients.

Conclusions:

  • While initial PAH care delivery and outcomes appear comparable between urban and rural patients, distinct treatment patterns and long-term risk trajectories emerge.
  • Differences in prostacyclin selection and risk reduction over time suggest potential care gaps or variations in response.
  • Further research is warranted to elucidate the factors driving these disparities and optimize PAH management across different geographic settings.