Document Type : Editorial


MD, Assistant Professor, Department of Cardiology, School of Medicine, Najaf Abad Branch Islamic Azad University


Pulmonary hypertension (PH) is a condition that,not only by itself causes many problems for those suffering from it,but also, it can exacerbate and complicate many other disease. PH can be responsible of mortality in many patients.Tackling PH is not exclusively related to the field of cardiovascular diseases. Many other disease in other fields of medicine may interfere with PH. Pulmonary diseases ,renal,hepatic,collagen vascular disease,infectious and hematologic disease may be deal with PH. In patients’ suffering from aforementioned diseases, PH can exacerbate primary disorder and even cause mortality. Pregnant women afflicted with PH have 30%-50% mortality rate.(1) Newborns and children with pulmonary or cardiovascular disorder can be later afflicted by PH. PH drastically increases risk in surgeries and in anesthesia and can be the cause of mortalities.(2) or detoriated outcome of patients after surgery.(3)According to the latest guidelines,(4) there are 5 categories of PH(table1): 1-Pulmonary arterial hypertension 2-Pulmonary venous hypertension(previously named pulmonary hypertension due to left heart disease) 3-Pulmonaey hypertension associated with hypoxemic lung disease 4- Pulmonary hypertension caused by chronic thromboembolic disease 5-Pulmonary hypertension from conditions with uncertain mechanisms For a long time, the science of medicine had no remedy for PH and physicians could only stand by and watch PH patients die .After some time factors which complicate PH are known and it were shown that control of these factors are helpful. Patients are advised, for instance, to refrain from heavy exertion, to avoid pregnancy, and to be vaccinated against flu and pneumococcal infections. PH patients’ life expectancy has increased drastically as a result of this newly acquired knowledge.As PH was becoming better known, symptomatic cures came to patients’ help. Diuretic drugs were used to control edema and anticoagulants were used to put tromboembolic attacks in check.Then,It was time of revolution in pulmonary hypertension management,With the emergence of Advanced PH treatment science of medicine became able to seriously deal with  PH.This new strategy were showed to be able preventing mortality in PH patients’(5),Figure1Prostacycline showed that it is possible to enhance PH patients’ chance of survival. Phosphodiasterase inhibitor drugs, which were used for treating impotency for a long time, were demonstrated to be effective for reducing pulmonary pressure. Eventually, endotheline receptors were targeted.By the advent of endothelin receptor blockers such as Brosentan, physicians’ chances of helping PH patients were further improved.Today, with advanced PH treatment, PH is not counted as before and the science of medicine as a failed discipline.It is important to not forgetting PH in patients,especially ill patients or intractable to traditional treatment, in surgery wards or obstetric,pediatric,internal medicine,ICU or CCU wards of hospitals. By timely diagnosis, it will be possible to control  PH patients in an effective way and to enhance their chance of survival.So,It is time now to pay more attention to PH,Don’t ignore it any longer and it’s time to deal with it