Compression Stockings Improve Lower Legs Symptom in Patients with Pulmonary Artery Hypertension Treated by Pulmonary Vasodilators—A Pilot Study

Abstract

Pulmonary vasodilators have improved pulmonary arterial hypertension (PAH) symptoms and prognosis; however, the drugs cause some side effects, including lower legs pain, which impair quality of life (QOL). The present study examined if compression stockings improved lower extremity symptoms and QOL caused by pulmonary vasodilators in PAH patients. We retrospectively enrolled consecutively ten patients with PAH treated by pulmonary vasodilators, who were regularly followed in Kurume University Hospital from January 2022 to June 2022. Oral questionnaire surveys, the Numeric Rating Scale for Pain (NRS) and the Pain Disability Assessment Scale (PDAS), were conducted regarding lower extremity symptoms before wearing elastic stockings and one month later, to evaluate how the lower extremity symptoms affected daily life. All ten patients were female, with a mean age of 50.2 ± 11.5 years, out of whom intravenous prostacyclin analogue (PGI2) was administered in five patients. In no intravenous PGI2 group, NRS score was significantly improved from 4.6 ± 2.3 to 2.8 ± 1.2 (p = 0.037), while from 9.4 ± 1.2 to 5.4 ± 1.6 (p = 0.002) in intravenous PGI2 group. PDAS score was also significantly improved [no intravenous PGI2 group; 18.0 (15.0–24.0) to 15.0 (10.0–19.0), intravenous PGI2 group; 25.0 (17.0–37.0) to 17.0 (5.0–27.0)]. Lower extremity symptoms in patients using pulmonary vasodilators were improved by wearing compression stockings.

Pathophysiology and Treatment of Pulmonary Arterial Hypertension

“…Despite advancements of pulmonary vasodilators (with various side effects [15]) over the past two decades, PAH and CTEPH remain serious conditions with significant morbidity and mortality [16]. To date, no treatments directly addressing the underlying causes of pulmonary arteriopathy have been developed.…”