Drug-Induced Pulmonary Arterial Hypertension: Mechanisms and Clinical Management

• Published in: Cardiovascular drugs and therapy Vol. 33; no. 6; pp. 725 - 738
• Main Authors: Correale, Michele, Tricarico, Lucia, Grazioli, Davide, Formica, Ennio Sascia, Petrucci, Rossella, Persichella, Paola, Di Biase, Matteo, Brunetti, Natale Daniele
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2019; Springer Nature B.V
• Subjects: Algorithms; Antiretroviral therapy; Cardiology; Disease control; Drug abuse; Drugs; HIV; Human immunodeficiency virus; Hypertension; Management; Medicine; Medicine & Public Health; Pulmonary hypertension; Rare diseases; Review Article; Drug-induced pulmonary hypertension; Pulmonary arterial hypertension; Pulmonary hypertension
• ISSN: 0920-3206; 1573-7241; 1573-7241
• DOI: 10.1007/s10557-019-06920-x

Pulmonary arterial hypertension is a rare disease, with drug-induced causes even more uncommon, accounting for only 10% of cases in large registry series. Predisposing factors for drug-induced PAH have not been completely defined. This review summarizes drugs with definite, possible, or likely association to pulmonary hypertension and possible mechanisms involved in the occurrence of pulmonary hypertension. Controversies on mechanisms and on their role in pathophysiology were also shown. The possible synergism between drug abuse and HIV was discussed and the possible interactions of antiretroviral therapy in HIV subjects were analyzed. Furthermore, we reported clinical findings and possible management, specific for each class of drugs, in case of drug-induced PAH. Finally, we summarized into a unified algorithm possible management of drug-induced PAH.