Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Oct 4;14(10):1265.
doi: 10.3390/life14101265.

Pulmonary Hypertension: Pharmacological and Non-Pharmacological Therapies

Jason Tsai  1 , Shaista Malik  1 , Stephanie C Tjen-A-Looi  1
Affiliations
Review

Pulmonary Hypertension: Pharmacological and Non-Pharmacological Therapies

Jason Tsai et al. Life (Basel). .

Abstract

Pulmonary hypertension (PH) is a severe and chronic disease characterized by increased pulmonary vascular resistance and remodeling, often precipitating right-sided heart dysfunction and death. Although the condition is progressive and incurable, current therapies for the disease focus on multiple different drugs and general supportive therapies to manage symptoms and prolong survival, ranging from medications more specific to pulmonary arterial hypertension (PAH) to exercise training. Moreover, there are multiple studies exploring novel experimental drugs and therapies including unique neurostimulation, to help better manage the disease. Here, we provide a narrative review focusing on current PH treatments that target multiple underlying biochemical mechanisms, including imbalances in vasoconstrictor-vasodilator and autonomic nervous system function, inflammation, and bone morphogenic protein (BMP) signaling. We also focus on the potential of novel therapies for managing PH, focusing on multiple types of neurostimulation including acupuncture. Lastly, we also touch upon the disease's different subgroups, clinical presentations and prognosis, diagnostics, demographics, and cost.

Keywords: alveolar hypoxia; cardiac dysfunction; chronic thromboembolic pulmonary hypertension (CTEPH); neurostimulation and electroacupuncture; pulmonary arterial hypertension (PAH); pulmonary hypertension (PH); vascular remodeling.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Tools used for pulmonary hypertension (PH) diagnosis and classification. Right heart catheterization is uniquely colored because it is required for the diagnosis of PH. Tools such as exercise testing or vasoreactivity testing can be utilized when performing right heart catheterization. This figure is only a summary: it does not include all the parameters that can be measured through diagnostic tools (e.g., chest radiography can also measure factors such as right atrial dilation) nor novel diagnostics currently being explored but not yet established (e.g., serum uric acid). mPAP = mean pulmonary arterial pressure, PAWP = pulmonary arterial wedge pressure, PVR = pulmonary vascular resistance, CO = cardiac output, SvO2 = mixed venous oxygen saturation, CTEPH = chronic thrombo-embolic PH, BNP = brain natriuretic peptide, NT-proBNP = N-terminal prohormone of BNP, TRVmax = maximum peak tricuspid regurgitation velocity, sPAP/PASP = pulmonary arterial systolic pressure, TAPSE = tricuspid annular plane systolic excursion, RVOT = right ventricular outflow tract, PaO2/PaCO2 = partial pressure of oxygen/carbon dioxide.
Figure 2
Figure 2
Potential mechanisms of acupuncture-mediated neurostimulation for pulmonary hypertension (PH).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Humbert M., Kovacs G., Hoeper M.M., Badagliacca R., Berger R.M., Brida M., Carlsen J., Coats A.J., Escribano-Subias P., Ferrari P., et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur. Respir. J. 2022;61:2200879. doi: 10.1183/13993003.00879-2022. - DOI - PubMed
    1. Simonneau G., Montani D., Celermajer D.S., Denton C.P., Gatzoulis M.A., Krowka M., Williams P.G., Souza R. Haemo-dynamic definitions and updated clinical classification of pulmonary hypertension. Eur. Respir. J. 2019;53:1801913. doi: 10.1183/13993003.01913-2018. - DOI - PMC - PubMed
    1. Hoeper M.M., Ghofrani H.A., Grünig E., Klose H., Olschewski H., Rosenkranz S. Pulmonary Hypertension. Dtsch. Arztebl. Int. 2017;114:73–84. doi: 10.3238/arztebl.2016.0073. - DOI - PMC - PubMed
    1. Barst R.J., Chung L., Zamanian R.T., Turner M., McGoon M.D. Functional Class Improvement and 3-Year Survival Outcomes in Patients with Pulmonary Arterial Hypertension in the REVEAL Registry. Chest. 2013;144:160–168. doi: 10.1378/chest.12-2417. - DOI - PubMed
    1. Sitbon O., Humbert M., Nunes H., Parent F., Garcia G., Hervé P., Rainisio M., Simonneau G. Long-term intravenous epoprostenol infusion in primary pulmonary hypertension: Prognostic factors and survival. J. Am. Coll. Cardiol. 2002;40:780–788. doi: 10.1016/S0735-1097(02)02012-0. - DOI - PubMed