2023-05-23 04:00:33
- Although the origin of some types of Pulmonary Arterial Hypertension is unknown, others are associated with connective tissue pathologies, chronic thrombosis, congenital heart disease and pulmonary emphysema.
- It is associated with multiple causes and each one requires different treatment.
- The WHO classifies it into five groups and this will depend on its origin and the way in which it is treated.
The Institute of Security and Social Services for State Workers (Issste) fulfills an important task by having more than 13 million beneficiaries. One of the most important achievements has been achieved with the different groups and types of pulmonary arterial hypertension (PAH) thanks to the therapeutic alternatives available and approved in Mexico.
ISSSTE quadruples survival of patients with pulmonary arterial hypertension
The general director, Pedro Zenteno Santaella, stressed that the institute is pioneer in the incorporation of advanced specific therapies for some types of primary PAH. As a consequence, in the last 15 years it has allowed to increase the survival of patients. Before it was 2.4 years; instead, it is now 10 years.
In this regard, the pulmonologist at the ISSSTE “1° de Octubre” Regional Hospital, highly specialized in interstitial lung disease (ILD) and PAHGuadalupe Espitia Hernández, specified that the white therapies that the institution has available are specific medications that act on different mechanisms of some variants.
“Currently, we care for patients who have undergone various treatment strategies and are surviving around 12 or 13 years under close medical surveillance by highly qualified multidisciplinary teams.”
PAH is a syndrome that brings together a series of conditions characterized by shortness of breath, blue coloration of the fingers and mouth, some heart murmurs, and swelling of the hands and feet. It can also be accompanied by heart failure and, if not treated in time, can cause death.
The World Health Organization (WHO) it classifies PAH into five groups and this will depend on its origin and the way in which it is treated.
Main types of pulmonary arterial hypertension
Group I integrates the variants of Idiopathic PAHs or PAHs of unknown cause, which includes a series of damages to health, ranging from genetic alterations, familial forms of the disease and an important segment of patients with idiopathic precapillary PAH, associated with diseases such as HIV; congenital heart disease of the interatrial or interventricular septal defect type, to which it is linked as a highly lethal complication.
“Its diagnosis is very important, because up to now, it is the only variant for which there is effective specific target therapy, to which ISSSTE beneficiaries have access and, in recent years, has managed to modify the survival of patients” .
There is also the postcapillary form of PAH in group II, which involves pathologies derived from the left heart, such as acute myocardial infarction and those who, apart from this, present some types of heart failure. It is the most common form of PAH worldwide and its management consists of treating the disease that triggers the failure.
Group III are patients with PAH plus lung damage, such as emphysema or idiopathic pulmonary fibrosis.
Variants of this syndrome associated with the chronic thrombotic disease, which causes the development of arthropathies, issues that damage the joints. In this segment, there are surgical treatment strategies and, in the case of non-operable patients, anticoagulation therapy and pharmacological management are available.
Patients with group V PAH have systemic causes. For example: lung cancer, thyroid disorders and kidney failure, which increase the pressure within the pulmonary arteries, but their origin is in structures outside the lung.
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