Pulmonary Hypertension (PH) is a condition in which the blood pressure in the pulmonary arteries becomes abnormally high, which places an excessive burden on the heart and can eventually lead to heart failure. This condition occurs when the walls of the pulmonary arteries become thickened, stiffened, or narrowed, restricting blood flow. Pulmonary hypertension is characterized by symptoms such as shortness of breath during exercise, chest pain, fatigue, and dizziness.
Five-year survival rates for pulmonary arterial hypertension (PAH) vary widely depending on the type of disease and treatment. In general, the five-year survival rate for pulmonary arterial hypertension (PAH) is reported to be about 50%, but this is influenced by multiple factors, so the prognosis in individual cases varies [91†source].
Pulmonary arterial hypertension progresses particularly quickly, and without appropriate treatment, survival rates are significantly reduced. However, recent advances in treatment have improved survival rates. Treatment of pulmonary hypertension includes calcium channel blockers, endothelin receptor antagonists, prostaglandin analogs, and phosphodiesterase 5 inhibitors, which are particularly effective in patients with pulmonary arterial hypertension [91†source].
Importantly, pulmonary hypertension requires specialized management for each individual case. Depending on the patient’s condition, medical history, and specific type of pulmonary hypertension, an appropriate treatment plan will be developed.
Treatment of Pulmonary Hypertension with PDE5 Inhibitors
PDE5 inhibitors were originally developed for the treatment of erectile dysfunction, but their vasodilating effects have also been found to be effective in the treatment of pulmonary hypertension. cGMP (cyclic guanosine monophosphate) is also present in lung tissue, where it is degraded. cGMP relaxes smooth muscle in blood vessels. Inhibition of cGMP degradation promotes dilation of the pulmonary arteries and improves blood flow in the lungs.
Main PDE5 inhibitors used:
- Sildenafil (Viagra, Revatio):.
- Sildenafil has been shown to reduce pressure in the pulmonary arteries in the treatment of pulmonary hypertension. By dilating the blood vessels in the lungs, this drug makes it easier for the heart to pump blood, resulting in improvement of symptoms and exercise tolerance.
- Tadalafil (Cialis, Adcirca):.
- Tadalafil is approved for use in the treatment of pulmonary hypertension due to its long half-life. It has a sustained vasodilating effect and helps patients increase their strength and improve their quality of life.
Treatment Effects and Precautions
Treatment with PDE5 inhibitors has been shown to reduce symptoms of pulmonary hypertension and improve patients’ exercise capacity.However, these drugs should be discussed in detail with a physician before use because of their interactions with other drugs and side effects (headache, indigestion, visual disturbances, etc.).In particular, concomitant use with nitrates and some antiarrhythmic drugs should be avoided.
Pulmonary hypertension is a progressive disease and can be life-threatening if left untreated. Therefore, early diagnosis and treatment with an appropriate treatment plan that includes PDE5 inhibitors is critical.
