Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland

I am delighted to write the foreword for this consensus statement which updates the ''Recommendations on the management of pulmonary hypertension in clinical practice'' of 2001.The consensus statement reflects contemporary practice in the management of this uncommon, deadly but now treatable condition in the pulmonary hypertension designated centres in the UK and Ireland.It matches and complements international guidelines, which are currently under revision.In addition to health professionals who encounter affected patients within national centres or in other fields of practice, the statement is a comprehensive but readily accessible source of information for commissioners and managers of specialised services.Initially the evidence on which to base the care of patients with rare and deadly diseases often rests on the experience and judgement of those who deliver daily care, the collection of clinical, epidemiological and pathological data, and the assiduous construction of informative registers.This familiar discipline has enabled the advances summarised in this document.The first challenge to health service commissioners is to ensure that all patients with pulmonary hypertension have access to appropriate therapy as quickly as possible.Delay in making the diagnosis has the same consequences as delay in those with cancer.Regrettably ''postcode prescribing'' and its consequences still persist.As for other uncommon conditions, continued progress in developing effective therapies rests on specialised centres working in concert to develop and participate in well-designed clinical trials, particularly trials of combination therapy.This statement is a testament to the major advances in therapy made over the last 10 years, progress those of us who have cared for such patients over more than 30 years could not have envisaged.