5 articles to raise awareness for pulmonary hypertension

The Pulmonary Hypertension Association has deemed November Pulmonary Hypertension Awareness month to raise awareness for pulmonary hypertension.

The campaign has a particular focus on chronic thromboembolic pulmonary hypertension (CTEPH) to raise awareness for pulmonary hypertension caused by chronic blood clots in the lungs; CTEPH Awareness Day was Nov. 21.

“CTEPH is an underdiagnosed and potentially curable disease as the cause is chronic recurrent clots in the lungs,” Zeenat Safdar, MD, program director of pulmonary hypertension and director of clinical research at Houston Methodist Lung Center, told Cardiology Today. “If these clots can be removed by surgery, then patients can be cured. In fact, Houston Methodist Hospital has a CTEPH program with expertise in surgical removal of these clots.”

According to Safdar, a diagnosis of pulmonary hypertension should be considered in patients who experience shortness of breath but have been cleared of other symptoms.

This is especially important in women, in whom it is more common, she said. “With proper diagnosis and treatment, [pulmonary hypertension] can be managed and outcomes can be improved.”

According to a press release from the Pulmonary Hypertension Association, its Right Heart campaign featured a newly-launched blog, Facebook videos and live social media events to share stories that illustrate how adults, teens and children with various forms of pulmonary hypertension are living their best lives.

A series of social media messages and memes were also used to educate the public about pulmonary hypertension and CTEPH.

In order to help raise awareness, Cardiology Today has compiled a list of articles reporting on pulmonary hypertension.

Ralinepag improves pulmonary vascular resistance in PAH

Patients with pulmonary artery hypertension who were treated with ralinepag in addition to single or dual background therapy had improved pulmonary vascular resistance compared with those treated with placebo, according to data presented at the CHEST annual meeting.

“It was ... a clinically meaningful effect that portends an improvement through something that would correspond in most cases with an improvement in terms of their symptoms, but more importantly in terms of their long-term outcomes,” Vallerie V. McLaughlin, MD, professor at University of Michigan Medical School in Ann Arbor, told Cardiology Today.

FDA approves third-generation nebulizer for inhalation system

The FDA approved a new inhalation device for use with a treprostinil inhalation system for the treatment of pulmonary arterial hypertension, according to a press release from United Therapeutics.

Treprostinil (Tyvaso) was approved in 2009 and the inhalation system consists of the drug product, an ultrasonic nebulizer and accessories. The Tyvaso system is the most prescribed inhalation therapy for PAH in the U.S., according to the release.

Beta-blockers safely benefit patients with PAH

Patients with pulmonary arterial hypertension who were treated with carvedilol had improved outcomes, according to a study published in JCI Insight.

“New therapies for right-sided heart failure and PAH have lagged behind left-sided heart failure, so there is vital need for new treatments,” W. H. Wilson Tang, MD, director of the Center for Clinical Genomics at the Cleveland Clinic, told Cardiology Today. “The fact that beta-blockers were well-tolerated and effective in lowering heart rates thereby improved the heart efficiency is a key observation, since doctors have been cautioned against using them in this setting for safety concerns. This study provided important new data that advances our knowledge of using this class of drugs in this chronic and life-threatening lung-associated vascular disease.”

Endothelin receptor antagonism may not improve outcomes in severe chronic HF

Patients with severe chronic HF treated with endothelin receptor antagonism did not experience improved outcomes, according to a study in JACC: Heart Failure.

The ENABLE trial consisted of two separate studies in Europe and Australia (ENABLE-1) and North America (ENABLE-2) from June 1999 to January 2002. Researchers analyzed data from 1,613 patients with NYHA class IIIb or IV HF symptoms for at least 2 months and left ventricular ejection fraction of less than 35%.

“This pharmacological action is of established value in the treatment of patients who have pulmonary hypertension due to a primary pulmonary vascular disorder in the absence of left [HF] (pulmonary arterial hypertension),” Milton Packer, MD, distinguished scholar in cardiovascular science at Baylor University Medical Center in Dallas, and colleagues wrote. “Such patients show improved exercise tolerance and symptoms and a reduced risk of disease progression. Given these benefits, physicians should distinguish [PAH] from pulmonary hypertension associated with chronic [HF] before prescribing endothelin receptor antagonists for long-term use.”

Women with PAH–congenital heart disease still advised against pregnancy

In women with pulmonary arterial hypertension associated with congenital heart disease, pregnancy outcomes were found to be better than previously thought, but patients should still be told not to get pregnant due to the severity of HF and a high rate of newborn complications, according to data published in Heart.