{"id":755,"date":"2020-02-17T22:00:37","date_gmt":"2020-02-17T16:30:37","guid":{"rendered":"https:\/\/medicineplexus.com\/?p=755"},"modified":"2020-02-17T22:00:37","modified_gmt":"2020-02-17T16:30:37","slug":"pharmacotherapy-of-pulmonary-hypertension","status":"publish","type":"post","link":"https:\/\/medicineplexus.com\/pharmacotherapy-of-pulmonary-hypertension\/","title":{"rendered":"Pharmacotherapy of Pulmonary Hypertension"},"content":{"rendered":"\n<p><strong>Pharmacotherapy of Pulmonary Hypertension<\/strong><\/p>\n\n\n\n<ul><li><strong>Definition- <\/strong>Pulmonary Hypertension (PH) is defined as an increase in mean pulmonary arterial pressure (PAPm) <strong>\u226525 mmHg<\/strong> at rest as assessed by right heart catheterization (RHC).<\/li><li>Normal (PAPm) \u2013 <strong>14 \u00b1 3 mmHg<\/strong><\/li><li>PAPm of 21 \u2013 24 mmHg \u2013 Carefully followed<\/li><\/ul>\n\n\n\n<p><strong>Classification \u2013 Based on Etiology<\/strong><\/p>\n\n\n\n<ul><li><strong>Group 1<\/strong><strong> \u2013 <\/strong>Pulmonary Arterial Hypertension <strong>Idiopathic Heritable \u00e0 BMPR2 mutationDrugs and toxins induced Associated with: Connective tissue diseaseHIV Infection Portal hypertension Congenital heart disease Schistosomiasis<\/strong><\/li><\/ul>\n\n\n\n<ul><li><strong>Group 2 <\/strong><strong>\u2013 <\/strong>PH Due to Left Heart Disease<strong><\/strong><\/li><li><strong>Group 3<\/strong><strong> \u2013 <\/strong>Pulmonary Hypertension Due to Lung Disease and\/or Hypoxia<strong><\/strong><\/li><li><strong>Group 4<\/strong><strong> \u2013 <\/strong>Chronic Thromboembolic Pulmonary Hypertension (CTEPH)<strong><\/strong><\/li><li><strong>Group 5<\/strong><strong> \u2013 <\/strong>Pulmonary Hypertension with Unclear Multifactorial Mechanisms<strong><\/strong><\/li><li><strong><u>PAH<\/u><\/strong><strong><\/strong><ul><li>Affects 15-50 people\/million &#8211; Globally<\/li><\/ul><ul><li>Affects all ages; most prevalent in <strong>4th &amp; 5th decades of life<\/strong><\/li><\/ul><ul><li>Higher prevalence in <strong>females <\/strong>than males (2-3:1 ratio)<\/li><\/ul><\/li><li><strong><u>PH due to Left Heart Disease<\/u><\/strong><strong> &#8211; <\/strong>most common cause of PH<strong><\/strong><\/li><\/ul>\n\n\n\n<p><strong>Pathophysiology<\/strong><\/p>\n\n\n\n<ul><li>Pulmonary vascular remodelling<\/li><li>Sustained pulmonary vasoconstriction<\/li><li>In- situ thrombosis<\/li><li>Pulmonary vascular wall stiffening<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"708\" height=\"316\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-316.png?w=708\" alt=\"\" class=\"wp-image-801\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-316.png 708w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-316-300x134.png 300w\" sizes=\"(max-width: 708px) 100vw, 708px\" \/><\/figure>\n\n\n\n<p><strong>Pathophysiology &amp; Targets<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"708\" height=\"486\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-317.png?w=708\" alt=\"\" class=\"wp-image-802\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-317.png 708w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-317-300x206.png 300w\" sizes=\"(max-width: 708px) 100vw, 708px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"721\" height=\"375\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-318.png?w=721\" alt=\"\" class=\"wp-image-803\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-318.png 721w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-318-300x156.png 300w\" sizes=\"(max-width: 721px) 100vw, 721px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"719\" height=\"428\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-319.png?w=719\" alt=\"\" class=\"wp-image-804\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-319.png 719w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-319-300x179.png 300w\" sizes=\"(max-width: 719px) 100vw, 719px\" \/><\/figure>\n\n\n\n<p><strong>WHO Functional Classification of Pulmonary Hypertension<\/strong><\/p>\n\n\n\n<p>Four functional classes have been defined for PAH:<\/p>\n\n\n\n<p>(I) no symptoms or functional limitation;<\/p>\n\n\n\n<p>(II) slight limitation of physical activity;<\/p>\n\n\n\n<p>(III) marked limitation of physical activity; and<\/p>\n\n\n\n<p>(IV) symptoms with any activity or at rest.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"641\" height=\"515\" src=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-320.png?w=641\" alt=\"\" class=\"wp-image-805\" srcset=\"https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-320.png 641w, https:\/\/medicineplexus.com\/wp-content\/uploads\/2020\/02\/image-320-300x241.png 300w\" sizes=\"(max-width: 641px) 100vw, 641px\" \/><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Pharmacotherapy of Pulmonary Hypertension Definition- Pulmonary Hypertension (PH) is defined as an increase in mean pulmonary arterial pressure (PAPm) \u226525 mmHg at rest as assessed by right heart catheterization (RHC). Normal (PAPm) \u2013 14 \u00b1 3 mmHg PAPm of 21 \u2013 24 mmHg \u2013 Carefully followed Classification \u2013 Based on Etiology Group 1 \u2013 Pulmonary[&#8230;]\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","footnotes":""},"categories":[3],"tags":[],"_links":{"self":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/755"}],"collection":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/comments?post=755"}],"version-history":[{"count":0,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/posts\/755\/revisions"}],"wp:attachment":[{"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/media?parent=755"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/categories?post=755"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicineplexus.com\/wp-json\/wp\/v2\/tags?post=755"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}