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Epidemiology and treatment of pulmonary arterial hypertension.
Nature Reviews Cardiology ( IF 49.6 ) Pub Date : 2017-06-08 , DOI: 10.1038/nrcardio.2017.84
Edmund M T Lau 1 , Eleni Giannoulatou 2, 3 , David S Celermajer 4, 5 , Marc Humbert 6, 7, 8
Affiliation  

In the past 2 decades, major changes have occurred in the epidemiological and treatment landscape of pulmonary arterial hypertension (PAH). Previously regarded as a disease of the young and middle-aged, contemporary registries from the Western world have demonstrated an increase in the age of patients with PAH, many of whom are elderly with multiple comorbidities. Another important observation is the improvement in survival of patients with PAH in the modern treatment era compared with historical cohorts, before the availability of advanced therapy. The management of PAH has also become more complex, and numerous drugs are now approved that target the endothelin 1, nitric oxide, and prostacyclin pathways. Combining drugs from different classes is now considered the standard of care and has been demonstrated to improve outcomes. Furthermore, the current treatment paradigm is the early use of combination therapy, often at the time of diagnosis, particularly in patients with severe disease. This Review provides a comprehensive update on the epidemiology and pharmacotherapy of PAH.

中文翻译:

肺动脉高压的流行病学和治疗。

在过去的20年中,肺动脉高压(PAH)的流行病学和治疗领域发生了重大变化。来自西方世界的当代登记册以前被认为是年轻人和中年人的疾病,已证明PAH患者的年龄在增加,其中许多是患有多种合并症的老年人。另一个重要的观察结果是,与历史上的队列研究相比,在获得先进治疗之前,PAH患者在现代治疗时代的生存率得到了改善。PAH的管理也变得更加复杂,现在已经批准了许多靶向内皮素1,一氧化氮和前列环素途径的药物。现在,将不同类别的药物组合起来被认为是护理的标准,并已被证明可以改善治疗效果。此外,当前的治疗范例是在诊断时通常是早期使用联合疗法,特别是在患有严重疾病的患者中。这篇综述提供了关于PAH的流行病学和药物治疗的全面更新。
更新日期:2017-09-04
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