Pulmonary Hypertension

Pulmonary hypertension (PH) — high blood pressure in the lungs — can’t be treated with standard hypertension drugs.

“It’s a relatively young field as far as treatment goes. Prior to the early ‘90s there was no therapy at all,” says Abby Poms, RRT and manager of the Center for Pulmonary Vascular Disease. 

Now there are more than a dozen approved therapies, and others are being investigated through clinical trials at Duke. “Historically, much of the access to medicines for these patients has been through clinical research and we continue to be very active in this area,” Poms says.

Treating and doing research into PH is a collaborative effort among physicians from the Division of Pulmonary, Allergy and Critical Care Medicine and the Division of Cardiology. That’s because PH is a disease of the lungs in which the right ventricle of the heart becomes damaged over time. “We have a fair amount of ongoing research targeting therapies to right ventricular function and determining the best ways to follow and measure right ventricular function,” Poms says.

In addition to conducting clinical trials, Duke physicians also conduct basic research into how PH works on a molecular level — which might open the door for future drug therapies. 

Duke is one of the few centers in the United States that perform surgery to treat a particular type of PH called chronic thromboembolic pulmonary hypertension (CTEPH), in which there are undissolved blood clots in the lungs. The surgery, called pulmonary thromboendarterectomy (PTE), can be life-changing for patients who are candidates for it. “People go from a difficult lifestyle — very short of breath, using oxygen, very limited — to feeling totally normal again.” Poms says more and more of this type of surgery has been taking place at Duke in the past five years.  She’d like to get the word out to referring physicians from other hospitals who may have CTEPH patients who could benefit from the surgery.