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Pulmonary Hypertension

Pulmonary Hypertension Hemodynamic classification of pulmonary hypertension relates to the hemodynamic mechanisms of pulmonary arterial hypertension, such as abnormalities of pulmonary blood flow, pulmonary vascular resistance, and pulmonary venous pressures. The therapeutic approaches can be directed to the hemodynamic mechanisms of pulmonary hypertension.The normal pulmonary arterial systolic pressure in healthy subjects ranges from 18 to 30 mm Hg and the diastolic pressure ranges from 4 to 12 mm Hg. Pulmonary hypertension is diagnosed when pulmonary arterial systolic and mean pressures exceed 30 and 20 mm Hg, respectively.The systolic pulmonary arterial pressure exceeding 35 mm Hg and mean pulmonary arterial pressure exceeding 30 mm Hg during exercise are also regarded as abnormal hemodynamic responses to exercise and indicate pulmonary hypertension. It should be appreciated that in the elderly population, pulmonary arterial pressure may be considerably higher, particularly during exercise in the absence of any discernible cause. The higher pulmonary arterial pressure in the elderly is primarily due to decreased compliance of the pulmonary artery, although pulmonary vascular resistance (PVR) increases as well with aging.The morphologic changes in the pulmonary vascular bed related to aging are increased in the intimal area of the smallest arteries, which reduce the lumen.Primary or unexplained pulmonary hypertension is being diagnosed with increasing frequency in the relatively older population. However, age-related changes in pulmonary arterial pressure (PAP) should be considered before such a diagnosis is established.CLASSIFICATION, ETIOLOGY, AND PATHOPHYSIO http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinte.162.17.1925
Publisher site
See Article on Publisher Site

Abstract

Hemodynamic classification of pulmonary hypertension relates to the hemodynamic mechanisms of pulmonary arterial hypertension, such as abnormalities of pulmonary blood flow, pulmonary vascular resistance, and pulmonary venous pressures. The therapeutic approaches can be directed to the hemodynamic mechanisms of pulmonary hypertension.The normal pulmonary arterial systolic pressure in healthy subjects ranges from 18 to 30 mm Hg and the diastolic pressure ranges from 4 to 12 mm Hg. Pulmonary hypertension is diagnosed when pulmonary arterial systolic and mean pressures exceed 30 and 20 mm Hg, respectively.The systolic pulmonary arterial pressure exceeding 35 mm Hg and mean pulmonary arterial pressure exceeding 30 mm Hg during exercise are also regarded as abnormal hemodynamic responses to exercise and indicate pulmonary hypertension. It should be appreciated that in the elderly population, pulmonary arterial pressure may be considerably higher, particularly during exercise in the absence of any discernible cause. The higher pulmonary arterial pressure in the elderly is primarily due to decreased compliance of the pulmonary artery, although pulmonary vascular resistance (PVR) increases as well with aging.The morphologic changes in the pulmonary vascular bed related to aging are increased in the intimal area of the smallest arteries, which reduce the lumen.Primary or unexplained pulmonary hypertension is being diagnosed with increasing frequency in the relatively older population. However, age-related changes in pulmonary arterial pressure (PAP) should be considered before such a diagnosis is established.CLASSIFICATION, ETIOLOGY, AND PATHOPHYSIO

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Sep 23, 2002

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