title: A study of clinical efficacy of sildenafil in patients with primary pulmonary hypertension.
abstract: BACKGROUND
  Primary pulmonary hypertension is a disorder with limited treatment options and poor outcome. Sildenafil, a pulmonary vasodilator, is likely to be beneficial in primary pulmonary hypertension. We studied the clinical efficacy of sildenafil in patients with primary pulmonary hypertension.
  
  
  RESULTS
  A registry of patients with primary pulmonary hypertension has been maintained in our hospital since January 1999. Of a total of 60 patients. 29 (M:16, F:13) consented to try sildenafiL. New York Heart Association functional class, six-minute walk test and Doppler echocardiographic evaluation of pulmonary artery pressure was done before and after treatment with sildenafil. Sildenafil was initiated at a dose of 25 mg thrice a day and increased up to 100 mg thrice a day as tolerated. There was a significant improvement in the functional class. The six-minute walked distance increased from 297.07+/-130.69 m at baseline to 427.68+/-85.35 m after 3 months of sildenafil therapy (p<0.0003). The mean of the pulmonary artery systolic pressure before starting sildenaffil was 109.26+/-24.15 mmHg (mean+/-SD) and it decreased to 95.15+/-24.64 mmHg (p<0.008). While 19 of the 31 historical controls in whom sildenafil was not given died during follow-up (11-44 months), only 1 of the 29 patients given sildenafil died (in an accident) during follow-up (5-20 months).
  
  
  CONCLUSIONS
  Sildenafil, a pulmonary vasodilator, has a beneficial effect in patients with primary pulmonary hypertension in improving the functional class, six-minute walked distance and in decreasing the pulmonary artery pressures.
authors.affiliation: Department of Cardiology, CARE Hospitals and CARE Foundation, Hyderabad. bkssastry@hotmail.com
authors.forename: B K S
authors.initials: BK
authors.lastname: Sastry
authors.forename: C
authors.initials: C
authors.lastname: Narasimhan
authors.forename: N K
authors.initials: NK
authors.lastname: Reddy
authors.forename: B
authors.initials: B
authors.lastname: Anand
authors.forename: G S
authors.initials: GS
authors.lastname: Prakash
authors.forename: P Raghava
authors.initials: PR
authors.lastname: Raju
authors.forename: D N
authors.initials: DN
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011446:Prospective Studies; D011687:Purines; D000068677:Sildenafil Citrate; D018709:Statistics, Nonparametric; D013450:Sulfones; D016019:Survival Analysis; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate