Obstructive pulmonary diseases and pulmonary hypertension

Pulmonary hypertension is a frequent complication of chronic obstructive pulmonary disease. Especially in patients with concurrent sleep apnoe syndrome (so called "overlap syndrome"), the risk for pulmonary hypertension is high. Pathophysiologically, both toxic effects (cigarette smoke) and alveolar hypoventilation can induce dysfunction of the pulmonary endothelium. Genetic factors and cytokines/growth factors released by inflammatory cells may induce remodeling of the pulmonary vessels. Pulmonary hypertension results, which is initially reversible, but gradually worsens over time. At present, therapeutic options include long term oxygen in addition to the treatment of the underlying disease. A subgroup of patients may profit of a specific therapy with sildenafil and other new substances. However, studies that define these subgroups need to be performed.