PAH Treatment Guidelines

PAH treatment guidelines are now available from the American Heart Association and the European society of Cardiology. These guidelines were developed based on the condition’s clinical features, as well as on the general health of patients with cardiovascular disease. This report reviews the latest guidelines for the management of this condition (pulmonary arterial hypertension).

pulmonary arterial hypertension treatment guidelines

The first set of PAH treatment guidelines was released in 2021. They were based on the assumption that people who suffer from this disease have a milder form of atherosclerosis. The second set of treatment guidelines was also released in 2021. Although the guidelines did not specifically mention cardiovascular disease, they were addressing the same issue as Dr. Melendr Spain, the father of modern cardiovascular research. He had shown, through his studies, that there is a little bit of atherosclerosis in the carotid arteries, but it does not cause serious problems.

Therefore, the first set of pulmonary arterial hypertension treatment guidelines advised patients to take high doses of calcium channel blocker drugs. Patients who do not respond well to calcium channel blocker drug therapy might find it beneficial to also take a blood-thinning agent, such as heparin or warfarin. While these agents can be effective for short-term measures, they may not be as effective in the long term. Patients who continue to take such drugs would develop bone deterioration, kidney damage, and heart attack.

Second, the treatment guidelines recommend the use of low-intensity, constant pressure cardio therapies for patients who do not respond to calcium channel blocker drugs or other preventive therapies. Examples of these cardio therapies include continuous positive airway pressure (CPAP), positive airway pressure (PAAP), and rescue breathing. Patients who respond well to these therapies should also receive diuretic therapy, in addition to oral diuretics. Oral hydrocortisone is an alternative therapy for some patients. However, it is not recommended for patients with severe heart failure or acute coronary syndromes. Lastly, patients are advised to undergo noninvasive interventions, such as medications and physical therapies, in order to improve their symptoms.

Third, the experts recommend regular exercise, which can be done on a daily basis, in addition to the medications. Aerobic exercises are known to reduce stress, increase oxygen intake, and stimulate the immune system. Furthermore, patients should maintain a stable lifestyle by decreasing smoking, limiting alcohol consumption, and leading a stress-free lifestyle. Medications, such as beta-blockers and antihypertensive drugs, are also commonly prescribed to treat pulmonary hypertension.

Fourth, the guidelines advise patients to maintain a 6-minute walk distance from home to work. The reason behind this recommendation is to decrease the stress on the heart. In addition, patients should also maintain an adequate diet, which contains sufficient amounts of protein, carbohydrates, and fat, according to the current opinion. Moreover, the experts recommend regular exercise testing to monitor the progress of the condition.

Fifth, there are specific treatment pathways. Pulmonary arterial hypertension can be treated using various approaches. One approach is to treat the stress on the heart by increasing the workload during breathing. This is done by reducing the workload during physical activity, thereby increasing the oxygen consumption rate. Another technique is by increasing the supply of oxygen to the brain through the blood pump. This is done by increasing the workload during the inspirations and respiratory diaphragm, thereby reducing the stress on the heart.

Finally, the guidelines also suggest different types of exercise programs for patients with pulmonary arterial hypertension. These exercise programs include steady state exercising, high intensity/low intensity exercising, swimming, jogging, bicycling, tennis, or playing games such as golf or soccer. For patients that do not want to perform any physical activities or prefer to avoid any type of exercise, they can use the therapy offered by the American College of Sports Medicine. The American College of Sports Medicine provides information and guidelines on various treatments and prevention of this condition.