title: Gender-related differences in pulmonary arterial hypertension targeted drugs administration.
abstract: During the last 15 years, a real "paradigm-shift" occurred, due to the development of PAH-targeted drugs, leading to crucial improvements in symptoms, exercise capacity, hemodynamics and outcome of PAH patients. In order to describe differences regarding epidemiology and therapy in PAH according to gender, we performed a review of the available literature in "PubMed" and "Web of Science" databases. In order to find relevant articles, we combined each of the following the keywords "pulmonary arterial hypertension", "gender", "sex", "men", "woman", "male", "female", "phosphodiesterase inhibitors", "endothelin receptor antagonists", "prostanoids". While there is a substantial agreement among epidemiological studies in reporting an increased prevalence of pulmonary arterial hypertension (PAH) among women, male PAH patients are affected by a higher impairment of the right ventricular function and consequently experience poorer outcomes. With regards to PAH-targeted drug administration, endothelin receptor antagonists (ERAs) and prostacyclin analogues (PC) show better treatment results in female PAH patients, while phosphodiesterase-5 inhibitors (PD5-I) seem to exert a more beneficial effect on male patients. However, to date no clear consensus could be formed by the available literature, which is constituted mainly by retrospective studies. Females with PAH are more prone to develop PAH, while males experience poorer outcomes. Females PAH might benefit more from ERAs and PC, while males seem to have more beneficial effects from PD5-I administration. However, more research is warranted in order to assess the most effective treatment for PAH patients according to gender.
authors: IRCCS SDN, Via Gianturco 113, 80143 Naples, Italy. Electronic address: alberto_marra@hotmail.it.
authors: Alberto M
authors: AM
authors: Marra
authors: Centre for Pulmonary Hypertension Thoraxclinic, University Hospital Heidelberg, Heidelberg, Germany.
authors: Nicola
authors: N
authors: Benjamin
authors: Centre for Pulmonary Hypertension Thoraxclinic, University Hospital Heidelberg, Heidelberg, Germany.
authors: Christina
authors: C
authors: Eichstaedt
authors: Department of Traslational Medical Sciences, "Federico II" Medicine School, Naples, Italy.
authors: Andrea
authors: A
authors: Salzano
authors: Department of Traslational Medical Sciences, "Federico II" Medicine School, Naples, Italy.
authors: Michele
authors: M
authors: Arcopinto
authors: Institute of Clinical Physiology, National Research Council, Pisa, Italy.
authors: Luna
authors: L
authors: Gargani
authors: Department of Cardiology, Second University of Naples - AORN dei Colli - Monaldi Hospital, Naples, Italy.
authors: Michele
authors: M
authors: D Alto
authors: Department of Cardiology, Second University of Naples - AORN dei Colli - Monaldi Hospital, Naples, Italy.
authors: Paola
authors: P
authors: Argiento
authors: Internal and Sub-intensive Medicine Department, A.O.U. "Ospedali Riuniti", Ancona, Italy.
authors: Lorenzo
authors: L
authors: Falsetti
authors: Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
authors: Paolo
authors: P
authors: Di Giosia
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors: Andrea M
authors: AM
authors: Isidori
authors: Department of Cardiology, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Italy.
authors: Francesco
authors: F
authors: Ferrara
authors: Department of Cardiology, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Italy.
authors: Eduardo
authors: E
authors: Bossone
authors: Department of Traslational Medical Sciences, "Federico II" Medicine School, Naples, Italy.
authors: Antonio
authors: A
authors: Cittadini
authors: Centre for Pulmonary Hypertension Thoraxclinic, University Hospital Heidelberg, Heidelberg, Germany.
authors: Ekkehard
authors: E
authors: Grünig
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D065128:Endothelin Receptor Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D011464:Epoprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D065128:Endothelin Receptor Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D011464:Epoprostenol
keywords: Female; Gender; Male; Pulmonary arterial hypertension; Risk stratification; Treatment