Key result
Elderly patients with pulmonary hypertension have more severe disease but are less likely to receive aggressive treatments such as double upfront oral combination or early parenteral prostacyclins.
Why the study?
Data on pulmonary hypertension treatments in older patients are limited due to a lack of dedicated geriatric clinical studies and the systematic exclusion of elderly patients with comorbidities from clinical trials.
Elderly patients with pulmonary hypertension are underrepresented in clinical trials and often undertreated in clinical practice, highlighting a need for targeted research and management strategies.
May support reevaluating treatment intensity in elderly PH; leaves open whether age-specific strategies improve outcomes.
INTRODUCTION: Despite an increasingly older pulmonary hypertension (PH) population, data on PH treatments in these patients are limited because there exist no clinical studies dedicated to geriatric groups. Furthermore, elderly patients with comorbidities have been systematically excluded from clinical trials, limiting the evidence base for drugs approved for pulmonary arterial hypertension (PAH). AREAS COVERED: This review is focused on the diagnosis and treatment of pulmonary hypertension (PH) in the elderly, which is a hot topic today. Areas covered by the authors include current changes in demographics, clinical characteristics, diagnoses, and risk assessment in the geriatric PAH population. A central part of this review is dedicated to the therapeutic challenges in elderly patients with PAH. The literature search is focused on sorting out post-capillary conditions in the elderly, and on current treatment strategies for PAH and for chronic thromboembolic pulmonary hypertension (CTEPH). EXPERT OPINION: Current data indicate that despite more severe disease in elderly patients, the concept of hit hard and early is less used. For example, double upfront oral combination, a common strategy for younger patients, or early parenteral prostacyclins, are less used in the elderly, purporting worse outcomes for these patients.
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Campean et al. (2020) conducted a review in Pulmonary hypertension in the elderly. Pulmonary hypertension treatments was evaluated. Elderly patients with pulmonary hypertension have more severe disease but are less likely to receive aggressive treatments such as double upfront oral combination or early parenteral prostacyclins.
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