This article includes introduction , classification , drugs , adverse effects , mechanisms of drugs and its symptoms and occurrences in class of patients

1. Recent Advances in the Treatment of Pulmonary Hypertension- An Update
K. Nabeen Patra* , Kiran Kumari Sahu, P. Narasimha Murthy, S.K. Panda
patranabeen@gmail.com
Royal College of Pharmacy and Health Sciences, Berhampur-760002, Odisha, India
Epidemiology
Introduction Signs and symptoms
Classification and Prevalence of PH according to
WHO
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Pulmonary hypertension(PH) can be defined as life threatening condition distinguished by high blood pressure that affects the arteries in lungs and right side of heart. It has been characterized by
progressive remodeling of distal pulmonary arteries and persistant elevation of pulmonary vascular resistance (PVR) that leads to right ventricular dysfunction, heart failure and finally death of
the individual. The symptoms includes dyspnea, fatique, syncope, ascities, cyanosis and palpitations. Etiologically, the WHO classified PH into 5 groups i.e., group 1 pulmonary arterial
hypertension, group 2 PH caused by left sided heart disease, group 3 PH caused by lung disease, PH caused by chronic blood clots, PH associated with other conditions that have unclear reasons.
The incidence and prevalence rate of PH (all groups) are increasing over time among which group 2 and 3 are the lethal forms. It is a rare disease with an emerging prevalence ranging from 10 to
52 cases per million. There has been number of medication which is developed for the treatment and prognosis of PH. However the treatment option develop to improve this condition, it
continuous to be worse day by day. With the clinical efficacy of some drugs being fully confirmed by year of practice, more and more attention have been obtained from the international
pharmaceutical industry. In this review, we
focus on summarizing some current developed drugs having therapeutic properties in PH and biological activity against relevant disease mechanism.
Keywords: pulmonary hypertension, disease mechanism, recent advances, treatment options
Abstract
Pulmonary hypertension is not in itself a diagnosis, but solely a
haemodynamic state characterized by resting mean pulmonary artery
pressure (PAPm) of ≥ 25 mm Hg. The term pulmonary arterial hypertension
describes a subgroup that is haemodynamically distinguished by pre-
capillary pulmonary hypertension with elevated pulmonary vascular
resistance (PVR), i.e., PAPm ≥ 25 mm Hg with normal pulmonary arterial
wedge pressure (PAWP) ≤ 15 mm Hg and PVR >240 dyn.
This applies particularly to lung disease and chronic thromboembolic
pulmonary hypertension, but also to left heart disease with normalised
PAWP. Pulmonary hypertension is by no means uncommon , on the
contrary, it probably affects around 1% of the global population. In those
over 65 years of age, the prevalence of pulmonary hypertension is thought to
be around 10% . However, the various forms of pulmonary hypertension
differ considerably in incidence and prevalence. In Germany, the incidence
of pulmonary arterial hypertension in 2014 was 3.9 per 1 million adults , the
prevalence was 25.9 per 1 million adults . In the same year the incidence of
chronic thromboembolic pulmonary hypertension was 4
Fig.no.1 Epidemiological data on prevalence of PH in India according
2018 survey
Drug treatment for PH
Pathogenesis
Fig.no. 2 Prevalence of different types of PH
References
Diagnosis
Electrocardiography, blood test and immunology, pulmonary
function test and arterial blood gases, cardiopulmonary exercise
testing, ventilation/ perfusion lung scanning and chest computed
tomography.
New treatment approaches for PH
The treatment process of PH patients cannot be limited to mere
prescription of drugs but is characterized by a complex strategy that
includes the initial evaluation of severity and the subsequent response
to treatment.[1] The overall goal of treatment is to achieve a low-risk
status whereby a patient is maintained in the WHO-FC II which is
usually accompanied by near-normal 6-min walk distance (6MWD).
Threshold of >440 m has been recommended by the Fifth WSPH.
The treatment of PH involves a three-pronged approach:
(1) General measures
(2) Specific drug therapy
(3) Reviewing the response to therapy.
* General measures in the management of PH include avoiding
pregnancy, immunization against influenza and pneumococcus,
psychosocial support, supervised exercise, and preference to epidural
anaesthesia over general anaesthesia
CONCLUSION
There are no specific studies documenting the incidence of
high-altitude PH among serving personnel in India. PH
remains a disease with significant morbidity, and our
understanding of its pathogenesis and management
continues to progress. With the future moving toward
personalized medicine, the growing pharmaceutical market
for PH, a significant progress in management, is expected
over the coming decades.
PULMONARY HYPERTENSION(WWW.aerzteblatt.de)
Resarch Articles- John J. Ryan, MD Director, Pulmonary Hypertension Center University of Utah, Division of Cardiovascular Medicine
Review of Advances in Management of Pulmonary Hypertension.--Surg Lt Cdr Manjit Sharad Tendolkar, Surg Cdr Rahul Tyagi, Surg Capt R. Ananthakrishnan1, Air Cmde Ajay Handa Departments of Pulmonary Medicine and 1Cardiology, INHS Asvini, Mumbai, Maharashtra, India
Review articles- The new England journal of medicine
Treatment of Pulmonary Arterial Hypertension-Marc Humbert, M.D., Ph.D., Olivier Sitbon, M.D., and Gérald Simonneau, M.D.
Images-Google,wikipedia,medicoimages.com
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