Treatment Considerations for Pulmonary Arterial Hypertension and Assessment of Treatment Response

Abstract

The process of considering initial treatment options for a patient with pulmonary arterial hypertension (PAH), implementing that treatment, and reassessing response can be conceived as a 7-step process. A patient-centered approach, conducted in the context of a pulmonary hypertension care team, implements these steps in a thoughtful and well-organized fashion.Step 1: Perform a thorough diagnostic evaluationStep 2: Consider patient PAH classification and comorbiditiesStep 3: Assess risk profileStep 4: Develop a nuanced understanding of patient goals and preferencesStep 5: Create an initial treatment strategyStep 6: Implement a proactive longitudinal follow-up care planStep 7: Adjust treatment approach based on clear metrics of effectiveness and tolerability The burgeoning array of treatment options for PAH provides the opportunity to tailor therapy to the needs of individual patients, but also demands that the clinician develop a cogent strategy for initiating therapy, monitoring therapeutic response, and addressing side effects of therapy. In this review, we seek to provide a practical framework for approaching this challenge.