Medical therapy of pulmonary hypertension. Conventional therapies.

摘要: The 1-, 3-, and 5-year survival rates of the patients included in National Institute Health Registry on Primary Pulmonary Hypertension were 77%, 41%, 27% respectively. It is unclear to what extent better applied conventional therapy contributes improved that now are reported with calcium-channel blockers, prostacyclin, or even transplantation. To date, by far most favorable results high-dose blockers combined anticoagulant therapy, at 3 years approximately 100%. has be emphasized, however, such exceptionally expected only a small minority who should not considered cured because, sooner later, their disease will continue evolve. Further improvements obviously needed for PAH. Interesting developments likely coming years, new multidrug approaches control pulmonary vasoreactivity remodeling and, hopefully, also progress lung past 2 decades have witnessed important treatment Although significant quality life rate been obtained prostacyclin perspectives offered atrial septostomy transplantation, evolved. Patients counseled more adequately regarding how remain physically active while avoiding exercise-induced anginal pain syncope. Invasive potentially risky medical procedures restricted favor noninvasive functional evaluations whenever possible. Risk factors as appetite suppressants, pregnancy, hypobaric hypoxia appreciated. indications supplemental oxygen, inotropic agents, diuretics refined based pathophysiologic understanding. Most benefit from coumarin derivatives, although some uncertainty remains about optimal international normalized ratio achieved. Safer acute reversibility testing performed fewer shorter-acting agents specific circulation select proportion long-term blocker therapy.