Pulmonary hypertension is due to increase in pressure of pulmonary artries. Some diseases can narrow the blood vessels in the lungs, which leads to high blood pressure in the lungs even when blood pressure in the rest of the body is normal. It may be due to lung diseases or heart diseases. Pulmonary hypertension is a highly fatal disorder since the strain of pumping blood through narrowed vessels often leads to failure of the heart muscle. When the heart muscle fails, the lungs cannot supply enough oxygen to meet the body's needs.

There are various treaments available for pulmonary hypertension. Goals of treament are

• Dilate pulmonary vessels
• Decrease thickening of blood
• Decrease preload on heart
• Increase oxygen supply to lungs
• Prevention and treatment of respiratory infection 
• Increase cardiac output
• Treat cause of secondary Pulmonary hypertension.

Any treatment which dilates pulmonary vessels can decease pulmonary hypertension. Treatments for this disorder widen the damaged blood vessels in the lung and make it easier for the heart to pump blood through the lungs. How can we dilate these pulmonary vessels?

One such drug (epoprostenol) is effective only if given intravenously through a small plastic tube that must remain in the vein permanently. Another treatment involves continuous inhalation of a gas (nitric oxide) that also widens blood vessels in the lungs. A newer approach has been an inhaled mist form of epoprostenol called iloprost. Because each mist treatment lasts only about 60 minutes, up to 12 treatments each day are required. Each of these treatments has its drawbacks and side effects. You cant take these orally, and have shorter duration of action. Recently, researchers learned that a drug Viagra (sildenafil citrate) the erectile-dysfunction drug used by more than 26 million men worldwide,can enhance and prolong the actions of both iloprost and nitric oxide.

New drug Revatio, which contains sildenafil citrate, the same active ingredient found in the erectile-dysfunction drug Viagra, has been approved by the Food and Drug Administration (FDA) for treating pulmonary hypertension.  Revatio is white and round; Viagra is a blue diamond.Will the drug work long-term? "Only time will tell," says Norman Edelman, medical director of the American Lung Association. "Anything that lowers blood pressure in the lungs and can do it over time will probably prolong life."

Good thing about this drug "it can be given orally, rather than intravenously or in an injection." The only other drug that can be given orally, Bosentan, can damage the liver. Studies are underway to see whether Revatio can be given with Bosentan and other drugs to yield an even bigger benefit.

Revatio's known side effects are typical of those for Viagra:  blue-tinged vision, muscle aches, flushing. Unwanted erections have been noted but very rare cases.

Although survival rates over 18 months increased from 65% to 95% with the use of Revatio, it is unknown if the drug will work long-term. When combined with standard treatments for pulmonary hypertension, sildenafil may significantly improve control of this fatal disease. Because experience with this treatment is limited, it is too early to make firm recommendations for treatment.
 
This article for Patients of pulmonary hypertension is presented for informational purposes only. This article is not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician

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