open access

Vol 27, No 2 (2020)
Review articles — Clinical cardiology
Published online: 2018-08-24
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Pulmonary arterial hypertension in the elderly: Clinical perspectives

Nicholas Rothbard, Abhinav Agrawal, Conrad Fischer, Arunabh Talwar, Sonu Sahni
DOI: 10.5603/CJ.a2018.0096
·
Pubmed: 30155860
·
Cardiol J 2020;27(2):184-193.

open access

Vol 27, No 2 (2020)
Review articles — Clinical cardiology
Published online: 2018-08-24

Abstract

Pulmonary hypertension (PH) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventric­ular failure and death. Pulmonary arterial hypertension (PAH) (World Health Organization Group I), a subset of PH, and may be idiopathic in nature or associated with other systemic conditions and is thought to most commonly effect women, the majority of whom are of childbearing age. However, PAH in the elderly population is being increasingly diagnosed creating clinical considerations that had once not been considered. Often in an elderly population the diagnosis of PAH may be delayed due to chronic comorbid conditions such as coronary artery disease or other dyspneic conditions. Though survival and clinical outcomes have improved, the elderly population continues to have disproportionately lower survival rates. High clinical suspicion of PAH warrants a complete diagnostic workup with right heart catheterization. Upon diagnosis, PAH specific therapy should be initiated with possible drug interactions in mind. Adjuvant pulmonary rehabilitation should be considered as a conservative measure with definitive results. Finally, psychosomatic aspects of the disease should also be considered in elderly populations.

Abstract

Pulmonary hypertension (PH) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventric­ular failure and death. Pulmonary arterial hypertension (PAH) (World Health Organization Group I), a subset of PH, and may be idiopathic in nature or associated with other systemic conditions and is thought to most commonly effect women, the majority of whom are of childbearing age. However, PAH in the elderly population is being increasingly diagnosed creating clinical considerations that had once not been considered. Often in an elderly population the diagnosis of PAH may be delayed due to chronic comorbid conditions such as coronary artery disease or other dyspneic conditions. Though survival and clinical outcomes have improved, the elderly population continues to have disproportionately lower survival rates. High clinical suspicion of PAH warrants a complete diagnostic workup with right heart catheterization. Upon diagnosis, PAH specific therapy should be initiated with possible drug interactions in mind. Adjuvant pulmonary rehabilitation should be considered as a conservative measure with definitive results. Finally, psychosomatic aspects of the disease should also be considered in elderly populations.

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Keywords

pulmonary hypertension, pulmonary arterial hypertension, pulmonary hypertension in the elderly, geriatric medicine, pulmonary vascular disease

About this article
Title

Pulmonary arterial hypertension in the elderly: Clinical perspectives

Journal

Cardiology Journal

Issue

Vol 27, No 2 (2020)

Pages

184-193

Published online

2018-08-24

DOI

10.5603/CJ.a2018.0096

Pubmed

30155860

Bibliographic record

Cardiol J 2020;27(2):184-193.

Keywords

pulmonary hypertension
pulmonary arterial hypertension
pulmonary hypertension in the elderly
geriatric medicine
pulmonary vascular disease

Authors

Nicholas Rothbard
Abhinav Agrawal
Conrad Fischer
Arunabh Talwar
Sonu Sahni

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