Once physicians know if it's the cause of PAH or just simply an overlap, comorbidities have to be closely monitored as disease progression.
As a progressive disease affecting both pulmonary and cardiovascular faculties in patients, pulmonary arterial hypertension (PAH) is an already cumbersome challenge for clinicians. Couple in any comorbidities patients develop, and it becomes an even more dire case.
In an interview with MD Magazine® while attending the 2018 CHEST Annual Meeting in San Antonio, TX, Gary Palmer, MD, MBA, Vice President of Medical Affairs for Actelion Pharmaceuticals and Victor Tapson, MD, Director of the Venous Thromboembolism & Pulmonary Vascular Disease Research Program at the Cedars-Sinai Medical Center, explained how comorbidities may manifest in patients with PAH, and why it's critical to monitor their status.
MD Mag: What are the comorbidities associated with PAH?
Tapson: Patients that have pulmonary arterial hypertension may have other illnesses. I mean, we always want to find the cause and the severity of the PH, to figure out if it’s PAH—then that's a disease we can approach with these medications.
It's important to control comorbidities. If somebody has asthma, COPD, other kinds of problems, if it's a major lung or cardiac problem, we have to determine if it just overlaps a little bit with this PAH, or if it's the cause. And if it's not the cause or is the cause, we have to make sure we treat that disease and keep it under control. The same is true with diabetes, hypertension, everything else. So, comorbidities can make this bad disease much worse.
Palmer: Keeping any concomitant concurrent illness or disease under control is important. I think what we see over time, as the disease progresses and patients get sicker and sicker, the comorbidities often cause them to end up in the hospital. And that's a negative predictor in this disease.
Unfortunately, the more often you end up in the hospital, with other problems and comorbidities, the more likely the patients are to progress and to actually die, ultimately. So, checking on the comorbidities is a way of actually checking the progression of the disease.
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