Journal Information
Vol. 44. Issue 2.
Pages 87-99 (January 2008)
Share
Share
Download PDF
More article options
Vol. 44. Issue 2.
Pages 87-99 (January 2008)
Consensus Statement
Full text access
Standards of Care in Pulmonary Hypertension*
Visits
5145
Joan Albert Barberàa,**, Pilar Escribanob,**, Pilar Moralesc, Miguel Ángel Gómezb, Mikel Oribed, Ángel Martíneze, Antonio Románf, Javier Segoviag, Francisco Santosh, María Teresa Subiranai
a Servicio de Neumología, Hospital Clínic, Barcelona, Spain
b Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain
c Unidad de Trasplante Pulmonar, Hospital La Fe, Valencia, Spain
d Servicio de Neumología, Hospital de Galdakao, Galdakao, Vizcaya, Spain
e Servicio de Cardiología, Hospital Virgen del Rocío, Sevilla, Spain
f Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
g Servicio de Cardiología, Hospital Puerta de Hierro, Madrid, Spain
h Servicio de Neumología, Hospital Reina Sofía, Córdoba, Spain
i Servicio de Cardiología, Hospital de Sant Pau, Barcelona, Spain
Ver más
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics

Substantial progress in the diagnosis and treatment of patients with pulmonary hypertension in recent years has led to significant improvement in survival. Evidence-based clinical practice guidelines issued by scientific societies reflect these new developments. However, certain clinically relevant issues have not been covered in consensus guidelines because of the lack of conclusive scientific evidence. Therefore, the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Cardiology (SEC) have promoted the present consensus statement in order to define national standards of care in the evaluation and management of pulmonary hypertension in its various forms, as well as to outline a clinical pathway and the basic principles for organizing health care in this clinical setting, with special emphasis on the requirements for and functions of specialized referral units. To prepare the statement, SEPAR and SEC formed a task force composed of national experts in various aspects of pulmonary hypertension. The resulting consensus is based on international clinical guidelines, a review of available scientific evidence, and panel discussion among the task force members. The final statement, approved by all participants, underwent external review.

Key words:
Pulmonary hypertension: diagnosis and therapy
Antihypertensive agents
Lung transplantation
Clinical practice guidelines

En los últimos años se han producido importantes avances en el diagnóstico y tratamiento de la hipertensión pulmonar que han logrado una mejoría significativa en la supervivencia de esta enfermedad. Estas innovaciones se han recogido en guías de práctica clínica basadas en la evidencia elaboradas por las sociedades científicas. Sin embargo, no se incluyen en ellas, por falta de evidencia científica concluyente, algunos aspectos que inciden en la práctica asistencial. Conscientes de ello, la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) y la Sociedad Española de Cardiología (SEC) han promovido la elaboración de un documento de consenso para definir en nuestro medio los estándares de calidad adecuados para el diagnóstico y tratamiento de la hipertensión pulmonar en sus diversas formas de presentación, así como la vía clínica y las directrices básicas de la organización asistencial del cuidado de estos pacientes, haciendo especial hincapié en los requisitos y funciones de las unidades de referencia. Para su redacción la SEPAR y la SEC designaron a un grupo de trabajo formado por expertos en los distintos aspectos de la enfermedad. Para la elaboración del documento se han utilizado las guías clínicas internacionales existentes, la revisión de la evidencia científica disponible y el debate en panel entre los expertos. El documento final, aprobado por todos los participantes, ha sido evaluado por revisores externos.

Palabras clave:
Hipertensión pulmonar
diagnóstico y tratamiento
Agentes antihipertensivos
Trasplante pulmonar
Guías de práctica clínica
Full text is only aviable in PDF
References
[1]
N Galie, A Torbicki, R Barst, P Dartevelle, S Haworth, T Higenbottam, et al.
Guías de práctica clínica sobre el diagnóstico y tratamiento de la hipertensión pulmonar.
Rev Esp Cardiol, 58 (2005), pp. 523-566
[2]
American College of Chest Physicians.
Diagnosis and management of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines.
Chest, 126 (2004), pp. S1-S92
[3]
DB Badesch, SH Abman, G Simonnean, LJ Rubin, W Mclaughlin.
Medical therapy for pulmonary arterial hypertension. Update ACCP evidence-based clinical practice guidelines.
Chest, 131 (2007), pp. 1917-1928
[4]
N Galie, LJ Rubin.
Pulmonary arterial hypertension epidemiology, pathobiology, assessment, and therapy.
J Am Coll Cardiol, 43 (2004), pp. 1S-90S
[5]
BM McQuillan, MH Picard, M Leavitt, AE Weyman.
Clinical correlates and reference intervals for pulmonary artery systolic pressure among echocardiographically normal subjects.
Circulation, 104 (2001), pp. 2797-2802
[6]
American Thoracic Society.
ATS statement: guidelines for the sixminute walk test.
Am J Respir Crit Care Med, 166 (2002), pp. 111-117
[7]
PL Enright, DL Sherrill.
Reference equations for the six-minute walk in healthy adults.
Am J Respir Crit Care Med, 158 (1998), pp. 1384-1387
[8]
O Sitbon, M Humbert, G Simoneau.
Les traitements de l'hypertension artérielle pulmonaire à l'heure de la T2A.
Press Med, 34 (2005), pp. 1455-1463
[9]
V McLaughlin, MD McGoon.
Pulmonary arterial hypertension.
Circulation, 114 (2006), pp. 1417-1431
[10]
JB Orens, M Estenne, S Arcasoy, JV Conte, P Corris, JJ Egan, et al.
International guidelines for the selection of lung transplant candidates: 2006 update – a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation.
J Heart Lung Transplant, 25 (2006), pp. 745-755
[11]
O Sitbon, M Humbert, H Nunes, F Parent, G García, P Herve, et al.
Long-term intravenous epoprostenol infusion in primary pulmonary hypertension: prognostic factors and survival.
J Am Coll Cardiol, 40 (2002), pp. 780-788
[12]
GP Diller, MA Gatzoulis.
Pulmonary vascular disease in adults with congenital heart disease.
Circulation, 115 (2007), pp. 1039-1050
[13]
R Rodríguez-Roisin, MJ Krowka, P Herve, MB Fallon.
Pulmonary hepatic vascular disorders (PHD).
Eur Respir J, 24 (2004), pp. 861-880
[14]
A Chaouat, AS Bugnet, N Kadaoui, R Schott, I Enache, A Ducolone, et al.
Severe pulmonary hypertension and chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 172 (2005), pp. 189-194
[15]
G Thabut, G Dauriat, JB Stern, D Logeart, A Levy, R Marrash-Chahla, et al.
Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation.
Chest, 127 (2005), pp. 1531-1536
[16]
S Provencher, O Sitbon, M Humbert, S Cabrol, X Jais, G Simonneau.
Long-term outcome with first-line bosentan therapy in idiopathic pulmonary arterial hypertension.
Eur Heart J, 27 (2006), pp. 589-595
[17]
R Wensel, CF Opitz, SD Anker, J Winkler, G Hoffken, FX Kleber, et al.
Assessment of survival in patients with primary pulmonary hypertension: importance of cardiopulmonary exercise testing.
Circulation, 106 (2002), pp. 319-324
[18]
M Humbert, O Sitbon, A Chaouat, M Bertocchi, G Habib, V Gressin, et al.
Pulmonary arterial hypertension in France: results from a national registry.
Am J Respir Crit Care Med, 173 (2006), pp. 1023-1030
[19]
LJ Rubin, DB Badesch.
Evaluation and management of the patient with pulmonary arterial hypertension.
Ann Inter Med, 143 (2005), pp. 282-292

The work leading to this consensus statement was funded by unrestricted grants received by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Cardiology (SEC) from the following companies: Actelion Pharmaceuticals España, Ferrer Grupo, GlaxoSmithKline, Pfizer, and Schering España.

The original Spanish article was published simultaneously in Rev Esp Cardiol. 2008;161(2): 170–84.

Coordinators

Copyright © 2008. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?