New Review of Pulmonary Arterial Hypertension Screening, Management, and Treatment Finds More Research Needed

More research is needed to determine the comparative validity, reliability, and feasibility of various screening, diagnostic, management, and treatment strategies for pulmonary arterial hypertension (PAH), according to a new AHRQ research review. This disease is rare and progressive, and, left untreated, can lead to heart failure and premature death. Specifically, the review finds that additional research is needed to determine if the combination of echocardiography and the biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) – two investigational diagnostic strategies for PAH – is sufficiently accurate to rule out the disease when testing patients with symptoms. More research is also needed to determine their effectiveness for screening asymptomatic patients who are at risk for PAH. Among patients with PAH, the biomarkers B-type natriuretic peptide (BNP) and uric acid, as well as the size of the right atrium of the heart and the presence of pericardial effusion (fluid around the heart) correlate with disease prognosis. Although the studies reviewed were not designed to detect a mortality reduction from treatment, all drug classes and combination therapy regimens improve the distance covered during the standard 6-minute walk test and reduce hospitalization rates when compared with placebo. However, comparisons between specific treatment regimens remain inconclusive. These findings are available in the research review, Pulmonary Arterial Hypertension: Screening, Management, and Treatment.