Risk Stratification – Guide of the Medical Therapy in Pulmonary Hypertension
Pécsi Tudományegyetem, Klinikai Központ, Szívgyógyászati Klinika, Pécs
The use of specific vasodilator drugs unequivocally improved the survival of the pulmonary arterial hypertension (PAH) during the last decades, but it still should be considered as a progressive condition with high mortality rate. The survival rate in PAH was also affected by the development of the therapeutic strategies: The regular risk stratification allows us to find the appropriately aggressive medical therapy. The multiparametric risk stratification approach suggested by the current ESC/ERS guideline reflects the real risk of the patients and may be reliably used both at baseline and during the follow-up. The overall treatment goal is achieving a low-risk status. Although patients with intermediate risk may appear clinically stable, generally this is a metastable state, therefore the use of more aggressive therapeutic strategies is pivotal also in this population. The efficiency of double or triple combination therapy is supported by strong evidences and their application is suggested in almost all patients with PAH.