Korean J Intern Med.  2019 Jul;34(4):696-707. 10.3904/kjim.2019.185.

Current status of pulmonary arterial hypertension in Korea

• Jang AY
• Chung WJ

• KMID: 2457302
• DOI: http://doi.org/10.3904/kjim.2019.185

Abstract

Pulmonary arterial hypertension (PAH) is characterized by remodeling of the distal pulmonary arteries resulting in high pulmonary vascular resistance and, eventually, right ventricular heart failure. Although current advances in PAH therapy have improved outcomes, poor survival remains a reality worldwide, including Korea. One of the most important issues in PAH is the late diagnosis, since screening or diagnostic efforts are often overlooked due to the rarity of disease. Data from Korean registries and observational cohorts show that delayed detection leads to increased morbidity. Additionally, low percentages of Korean patients are committed to intensive PAH-targeted therapy. Current Korean health insurance policies' lack of coverage for new PAH-targeted drugs and upfront combination therapy may also hamper the improvement of treatment outcomes. Understanding individual variability in response to therapeutics through deep phenotyping is a novel strategy that should be considered when treating PAH. Overall, early detection of PAH by proactive screening together with early, intensive, individualized PAH therapy using deep phenotyping is crucial for improving prognoses for PAH patients in Korea.

Keyword

Pulmonary arterial hypertension; Early diagnosis; Pharmacotherapy; Phenotyping; Precision medicine

MeSH Terms

Cohort Studies
Delayed Diagnosis
Drug Therapy
Early Diagnosis
Heart Failure
Humans
Hypertension*
Insurance, Health
Korea*
Mass Screening
Precision Medicine
Prognosis
Pulmonary Artery
Registries
Vascular Resistance