Treating pulmonary hypertension in the elderly

Campean, Ioana A; Lang, Irene

doi:10.1080/14656566.2020.1739270

Cited by 5 publications

(6 citation statements)

References 42 publications

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“…Nonetheless, only 9% of the sample we analyzed was treated with triple oral therapy, including selexipag. No patient received subcutaneous treprostinil, and intravenous epoprostenol was administered only to one subject, indicating that treatment of PAH in the elderly is less aggressive than recommended, as already described [ 24 ].…”

Section: Discussionmentioning

confidence: 93%

Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry

Toma

Miceli

Bonsante

et al. 2022

JCM

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Pulmonary arterial hypertension (PAH) in the elderly is often associated with left heart disease (LHD), prompting concerns about the use of pulmonary vasodilators. The PATRIARCA registry enrolled ≥70 year-old PAH or chronic thromboembolic pulmonary hypertension (CTEPH) patients at 11 Italian centers from 1 December 2019 through 15 September 2022. After excluding those with CTEPH, post-capillary PH at the diagnostic right heart catheterization (RHC), and/or incomplete data, 23 (33%) of a total of 69 subjects met the criteria proposed in the AMBITION trial to suspect LHD. Diabetes [9 (39%) vs 6 (13%), p = 0.01] and chronic kidney disease [14 (61%) vs 12 (26%), p = 0.003] were more common, and the last RHC pulmonary artery wedge pressure [14 ± 5 vs 10 ± 3 mmHg, p < 0.001] was higher and pulmonary vascular resistance [5.56 ± 3.31 vs 8.30 ± 4.80, p = 0.02] was lower in LHD than non-LHD patients. However, PAH therapy was similar, with 13 (57%) and 23 (50%) subjects, respectively, taking two oral drugs. PAH medication patterns remained comparable between LHD and non-LHD patients also when the former [37, 54%] were identified by atrial fibrillation and echocardiographic features of LHD, in addition to the AMBITION criteria. In this real-world snapshot, elderly PAH patients were treated with pulmonary vasodilators, including combinations, despite a remarkable prevalence of a LHD phenotype.

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Section: Discussionmentioning

confidence: 93%

Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry

Toma

Miceli

Bonsante

et al. 2022

JCM

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“…23 However, elderly patients with PAH may benefit less from the rapidly growing number of new agents for PAH than young patients because they underwent combination drug regimen less frequently than young patients. 24 Evidence also demonstrated that elderly patients exhibited a poorer response to these medications than young patients. 8 A PAH registry from the UK and Ireland reported that a higher proportion of young patients received sequential combination therapy (57.6% vs. 34.5%, respectively; p < 0.001), triple therapy (10.6% vs. 1.3%; p < 0.001), prostaglandins (51.8% vs. 28.1%; p < 0.001), calcium channel blocker (10.2% vs. 3%; p < 0.002), and transplantation (5.3% vs. 0.4%; p < 0.002) than their elderly counterparts.…”

Section: Treatments and Treatment Responsementioning

confidence: 99%

Pulmonary arterial hypertension in the elderly population

Chen

Hung

Chiang

et al. 2022

Journal of the Chinese Medical Association

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Pulmonary arterial hypertension (PAH) was a disease predominantly affecting young females about 40 years ago; however, it has been increasingly diagnosed in elderly individuals. Few studies have investigated the features of elderly patients with PAH. This review provides an overview of the characteristics of elderly patients with PAH compared to young patients. The examination of the changing demographics of the population with PAH revealed that the mean age has increased over the years. In addition, the investigation into the diagnostic challenges in elderly patients with PAH revealed the difficulty in differentiating PAH from pulmonary hypertension secondary to diastolic heart failure. Moreover, it was noted that elderly patients underwent combination drug regimens less frequently and exhibited poorer treatment responses than young patients. Finally, it was found that elderly PAH patients experienced poorer survival than young patients. The differences among five survival prediction models and their applicability in predicting the prognosis of PAH patients are discussed.

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“…Таким образом, высокая смертность у пожилых пациентов с ЛГ, вероятно, может быть связана как с коморбидным статусом и уникальным фенотипом заболевания, так и с рядом особенностей, обусловленных различными подходами к лечению и нестандартным ответом на специфическую терапию [15][16][17].…”

Section: цели терапии пациентов с лагunclassified

Combination therapy of newly diagnosed intermediate-risk pulmonary arterial hypertension: A review

2022

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Advancements in the specific therapy of pulmonary arterial hypertension (PAH) and new combination therapy strategies and escalation treatment over the past decade have significantly improved disease control, slowed its progression, and improved quality of life and patient survival. This review provides a detailed discussion of current strategies for PAH-specific therapy available in the Russian Federation for patients with classical and non-classical PAH who fail to achieve treatment goals and remain at intermediate risk of disease progression/mortality.

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Treating pulmonary hypertension in the elderly

Cited by 5 publications

References 42 publications

Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry

Left Heart Disease Phenotype in Elderly Patients with Pulmonary Arterial Hypertension: Insights from the Italian PATRIARCA Registry

Pulmonary arterial hypertension in the elderly population

Combination therapy of newly diagnosed intermediate-risk pulmonary arterial hypertension: A review

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