Pulmonary Hypertension in Women.

Publisher: Methodist DeBakey Heart & Vascular Center Country of Publication: United States NLM ID: 101508600 Publication Model: eCollection Cited Medium: Internet ISSN: 1947-6108 (Electronic) Linking ISSN: 19476108 NLM ISO Abbreviation: Methodist Debakey Cardiovasc J Subsets: MEDLINE

Original Publication: Houston, TX : Methodist DeBakey Heart & Vascular Center

Hypertension, Pulmonary*/diagnosis ; Hypertension, Pulmonary*/epidemiology ; Hypertension, Pulmonary*/therapy ; Hypertension*; Female ; Pregnancy ; Humans ; Male ; Cesarean Section/adverse effects ; Pregnancy Outcome ; Familial Primary Pulmonary Hypertension/complications

Pulmonary arterial hypertension (PAH) is a rare devastating disease characterized by elevated pulmonary artery pressure and increased pulmonary vascular resistance. Females have a higher incidence of PAH, which is reflected globally across registries in the United States, Europe, and Asia. However, despite female predominance, women had better outcomes compared with male patients, a finding that has been labeled the "estrogen paradox." Special considerations should be given to women with PAH regarding sexual health, contraception, family planning, and treatment before, during, and after pregnancy. Pregnant women with PAH should be referred to a pulmonary hypertension care center; a multidisciplinary team approach is recommended, and Cesarean section is the preferred mode of delivery. While pregnancy outcomes have improved over the years with PAH-specific therapy, pregnancy portends a high-risk for those with PAH. Continued research is needed to tailor PAH treatment for women.
Competing Interests: The authors have no competing interests to declare.
(Copyright: © 2024 The Author(s).)

BMC Pregnancy Childbirth. 2023 Jun 8;23(1):427. (PMID: 37291508)
Cureus. 2022 Dec 7;14(12):e32284. (PMID: 36627983)
Compr Physiol. 2019 Dec 18;10(1):125-170. (PMID: 31853950)
ERJ Open Res. 2023 Mar 13;9(2):. (PMID: 36923571)
Ir Med J. 2005 Mar;98(3):87-8. (PMID: 15869069)
Am J Physiol Lung Cell Mol Physiol. 2012 May 15;302(10):L977-91. (PMID: 22307907)
Front Cardiovasc Med. 2021 Sep 10;8:719058. (PMID: 34568460)
Ther Adv Respir Dis. 2013 Feb;7(1):51-63. (PMID: 23060536)
Eur Respir Rev. 2021 Nov 8;30(162):. (PMID: 34750113)
Vasc Health Risk Manag. 2023 Mar 03;19:103-126. (PMID: 36895278)
Chest. 2013 May;143(5):1330-1336. (PMID: 23100080)
BMC Pregnancy Childbirth. 2023 Jan 9;23(1):16. (PMID: 36624418)
Eur Respir J. 2007 Jul;30(1):104-9. (PMID: 17360728)
BMC Pulm Med. 2023 Feb 11;23(1):62. (PMID: 36765334)
J Am Coll Cardiol. 2013 Dec 24;62(25 Suppl):D51-9. (PMID: 24355642)
Circulation. 2023 Feb 14;147(7):549-561. (PMID: 36780387)
Tex Heart Inst J. 2013;40(3):302-3. (PMID: 23914026)
Heart Fail Clin. 2019 Jan;15(1):137-145. (PMID: 30449376)
Semin Respir Crit Care Med. 2013 Oct;34(5):681-8. (PMID: 24037634)
J Pharm Biomed Anal. 2016 Feb 20;120:100-5. (PMID: 26717019)
JAMA. 2022 Apr 12;327(14):1379-1391. (PMID: 35412560)
J Cardiovasc Dev Dis. 2022 Jun 18;9(6):. (PMID: 35735823)
Heart Lung. 2021 Sep-Oct;50(5):714-719. (PMID: 34107396)
N Engl J Med. 2023 Apr 20;388(16):1478-1490. (PMID: 36877098)
Pulm Circ. 2015 Sep;5(3):435-65. (PMID: 26401246)
Front Aging. 2021 Oct 04;2:727558. (PMID: 35822006)
Eur Respir Rev. 2013 Dec;22(130):535-42. (PMID: 24293469)
Eur Respir J. 2012 Sep;40(3):596-603. (PMID: 22362843)
Pulm Circ. 2018 Jul-Sep;8(3):2045894018780521. (PMID: 29767576)
J Am Coll Cardiol. 2019 Feb 5;73(4):457-476. (PMID: 30704579)
Eur Respir J. 2023 Jan 6;61(1):. (PMID: 36028254)
Pulm Circ. 2021 Nov 11;11(4):20458940211057071. (PMID: 34790348)
Semin Thromb Hemost. 2003 Apr;29(2):125-30. (PMID: 12709915)
Front Med. 2012 Sep;6(3):307-10. (PMID: 22855123)
Clin Chest Med. 2021 Mar;42(1):217-228. (PMID: 33541615)
Chest. 2012 Feb;141(2):363-373. (PMID: 21757572)
J Heart Lung Transplant. 2017 Jul;36(7):770-779. (PMID: 28190786)
Eur Respir J. 2019 Jan 24;53(1):. (PMID: 30545971)
Int J Cardiol. 2013 Sep 30;168(2):871-80. (PMID: 23164592)
Front Med (Lausanne). 2021 Jul 05;8:689764. (PMID: 34291063)
Br J Pharmacol. 2014 Feb;171(3):567-79. (PMID: 23802760)
Circulation. 2010 Jul 13;122(2):156-63. (PMID: 20585011)
Arch Sex Behav. 2022 Apr;51(3):1647-1657. (PMID: 35165801)
N Engl J Med. 2021 Apr 1;384(13):1204-1215. (PMID: 33789009)
Eur Respir Rev. 2016 Dec;25(142):431-437. (PMID: 27903665)
Am J Physiol Lung Cell Mol Physiol. 2014 Jul 1;307(1):L7-26. (PMID: 24816487)
Circ J. 2017 Dec 25;82(1):275-282. (PMID: 28747612)
Eur Respir Rev. 2012 Mar 1;21(123):8-18. (PMID: 22379169)
Front Pharmacol. 2022 Jun 15;13:881084. (PMID: 35784689)

Keywords: estrogen paradox; heart disease in women; pulmonary arterial hypertension; pulmonary hypertension

Date Created: 20240318 Date Completed: 20240319 Latest Revision: 20240319

20240319

PMC10941702

10.14797/mdcvj.1308

38495664