Drug-Induced Pulmonary Arterial Hypertension: Mechanisms and Clinical Management

Cardiovasc Drugs Ther. 2019 Dec;33(6):725-738. doi: 10.1007/s10557-019-06920-x.

Abstract

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.

Keywords: Drug-induced pulmonary hypertension; Pulmonary arterial hypertension; Pulmonary hypertension.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Animals
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Arterial Pressure / drug effects*
  • Clinical Decision-Making
  • Decision Support Techniques
  • Humans
  • Pulmonary Arterial Hypertension / chemically induced*
  • Pulmonary Arterial Hypertension / drug therapy*
  • Pulmonary Arterial Hypertension / physiopathology
  • Pulmonary Artery / drug effects*
  • Pulmonary Artery / physiopathology
  • Risk Factors
  • Treatment Outcome

Substances

  • Antihypertensive Agents