General treatment strategy

Treating patients with pulmonary hypertension presents a formidable challenge for cardiologists and general practitioners, leading to the establishment of specialized centers worldwide. The primary objectives in pulmonary hypertension treatment are to address its root cause, reduce pulmonary artery blood pressure, and prevent blood clots in pulmonary vessels.

Despite the absence of a cure, therapeutic progress over the past two decades has significantly enhanced the quality of life and extended survival for pulmonary hypertension patients. The current treatment approach for pulmonary hypertension primarily involves:

  • Restriction of physical activity
  • Long-term anticoagulation
  • Vasodilator therapy

Treatment Strategy:

Medical and interventional procedures in advanced stages of the disease are invasive and have significant side effects. Therefore, the treatment of pulmonary arterial hypertension (PAH) requires a comprehensive strategy, including:

  • Assessment of severity or functional class (FC) to establish appropriate therapy (FC I-IV); prescription of general and individual treatment (diuretics, oxygen, anticoagulants, digoxin).
  • Assessment of vasoreactivity: performed during pulmonary artery and right heart catheterization, allowing identification of patients who may benefit from long-term therapy with calcium channel blockers (approximately 10%).
  • Assessment of treatment effectiveness when combining different drugs - drugs from different groups (Endothelin receptor antagonists (ERA), Phosphodiesterase type-5 ("PDE-5") inhibitors, Prostanoids) can be used as monotherapy, double, or even triple combination therapy.
  • Decision to perform surgical intervention (transplantation, atrial septostomy, endoarterectomy).

Throughout all stages of treatment, the knowledge and experience of treating physicians are crucial to optimizing available resources.

The Ministry of Health of Ukraine, through its Order dated June 21, 2016 (No. 614), officially sanctioned and implemented medical and technological documents for standardizing medical care for pulmonary hypertension. This endorsement includes the approval of guidelines and protocols specific to pulmonary hypertension