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Controversies in the Management of Pulmonary Hypertension in the Setting of Lung Disease

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Pulmonary Hypertension

Part of the book series: Respiratory Medicine ((RM))

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Abstract

Pulmonary hypertension (PH) commonly complicates the course of many patients with chronic lung disease (CLD-PH). Although the PH tends to be mild to moderate, it has a strong association with reduced functional ability, greater oxygen requirements, and increased mortality. The availability of multiple drugs to treat group 1 pulmonary arterial hypertension has brought to the forefront the notion of treating CLD-PH with these same medications. This remains a highly controversial issue with some studies suggesting benefit and others demonstrating harm. In this chapter we provide an overview of CLD-PH and provide arguments to treat and not to treat, with recommendations to assist clinicians in the trenches.

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Author information

Authors and Affiliations

  1. Inova Heart and Vascular Institute, Inova Fairfax Hospital, Falls Church, VA, USA

    Steven D. Nathan

  2. Department of Pulmonary Medicine and Allergy, Hospital Clínic – Biomedical Research Institute August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain

    Joan Albert Barberà

  3. Biomedical Research Networking Center on Respiratory Diseases (CIBERES), Madrid, Spain

    Joan Albert Barberà

Authors
  1. Steven D. Nathan
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  2. Joan Albert Barberà
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Corresponding author

Correspondence to Steven D. Nathan .

Editor information

Editors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Department of Medicine Pulmonary Hypertension Program University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    H. James Ford

  2. Department of Pulmonary, and Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA

    Gustavo A. Heresi

  3. Division of Pulmonary Allergy and Critical Care Medicine, Pittsburgh Heart, Lung Blood and Vascular Medicine Institute University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Michael G. Risbano

Glossary

6MWT

Six-minute walk test

COPD

Chronic obstructive pulmonary disease

CT

Computed tomography

DLCO

Single-breath diffusing capacity for carbon monoxide

FVC

Forced vital capacity

IPF

Idiopathic pulmonary fibrosis

mPAP

Mean pulmonary artery pressure

PAH

Pulmonary arterial hypertension

PFTs

Pulmonary function tests

PH

Pulmonary hypertension

RCT

Randomized controlled trials

RISE-IIP

A randomized, double-blind, placebo-controlled phase II study to investigate the efficacy and safety of riociguat in patients with symptomatic pulmonary hypertension associated with idiopathic interstitial pneumonias

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Nathan, S.D., Barberà, J.A. (2020). Controversies in the Management of Pulmonary Hypertension in the Setting of Lung Disease. In: Ford, H.J., Heresi, G.A., Risbano, M.G. (eds) Pulmonary Hypertension. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-52787-7_7

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  • DOI: https://doi.org/10.1007/978-3-030-52787-7_7

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-52786-0

  • Online ISBN: 978-3-030-52787-7

  • eBook Packages: MedicineMedicine (R0)

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