Abstract
The first clinical classification and hemodynamic definition of pulmonary hypertension (PH) was introduced at a WHO meeting in Geneva in 1973. The diagnostic classification was updated at the world conference in Evian, 1998, introducing 5 clinical groups instead of the original groups of primary and secondary PH. Although changes have been made, the basic structure of this classification was adopted in the following world congresses in Venice 2003 and Dana Point 2008.Since 1973, PH was hemodynamically defined as mean pulmonary arterial pressure (PAP) >25 mmHg at rest or >30 mmHg during exercise. In 2008, the hemodynamic definition was discussed again. The analysis of the published data, based on invasive measurements in healthy individuals, suggested that resting PAP is 14.0±3.3 mmHg and independent of gender and is only mildly influenced by posture and age. During exercise, however, PAP is dependent on exercise level and age. Accordingly, the Dana Point statement defines the normal range of resting mean PAP between 8 and 20 mmHg and PH as resting mean PAP ≥25 mmHg. The exercise part of the old definition of PH was abandoned.
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