History of Respiratory Medicine in Canada: Pulmonary hypertension

Pulmonary hypertension (PH) is a serious, progressive, and often fatal clinical-physiologic syndrome. PH is defined by elevated mean pulmonary artery pressure (PAP), typically complicated by right ventricular (RV) failure in advanced stages, and affected patients suffer symptoms, disability, and premature mortality. PH has been a focus of basic and clinical research since the 1950s, with important contributions by many cardiopulmonary clinicians and scientists in multiple Canadian institutions. The history of PH in Canada starts from the earliest reports of electrocardiogram (EKG) diagnosis of PH and care of children with PH associated with congenital heart disease. Innovative basic science research greatly expanded our understanding of the pathobiology of PH, and subsequent clinical translational research advanced our ability to diagnose, assess, and treat patients with PH-targeted medications and surgical approaches, especially for WHO group 1 pulmonary arterial hypertension (PAH) and WHO group 4 chronic thromboembolic PH (CTEPH). Moreover, development of a network of PH expert centers spanning across Canada supported national collaborative excellence in education, clinical care and research. These centers and treatments have helped to significantly prolong and improve the lives of Canadian patients affected by PH. Furthermore, grassroots efforts by patients and their caregivers to support others similarly affected by PH led to development of a national PH community supported by the nonprofit Pulmonary Hypertension Association (PHA) of Canada. True to the spirit of the "History of Respiratory Medicine in Canada", conceived by Louis-Philippe Boulet, this article captures the history and excellence of Canadian contributions to the field of PH.