New insights in pulmonary hypertension

Irish Society for Rheumatology, Spring Meeting, Sligo Park Hotel, 10-11 April 2025

The landscape for pulmonary hypertension (PH) in relation to diagnosis and treatment has improved significantly in the last two decades, with further improvements on the horizon, the 2025 Irish Society for Rheumatology Spring Meeting heard.

Prof Sean Gaine, Consultant Respiratory Physician at the Mater Misericordiae University Hospital in Dublin and Director of the National Pulmonary Hypertension Unit, gave a comprehensive update on the developments over his career.

Prof Gaine has researched and published widely on PH and become a noted award-winning international expert in the disease.

The complexity of managing PH requires a multi-faceted, holistic, and multi-disciplinary approach, with active involvement of patients in partnership with clinicians. Streamlining the care of patients with PH in daily clinical practice is a challenging but essential requirement for effectively managing PH, he said.

Due to the overlap between different PH phenotypes in systemic sclerosis, a comprehensive diagnostic work-up is crucial, he said, adding that proper risk stratification determines treatment approaches.

In recent years, substantial progress has been made in detecting and managing PH, and new evidence has been integrated in the latest edition of the European Society of Cardiology/European Respiratory Society diagnosis and treatment guidelines, Prof Gaine told the meeting.

Discussing screening of these patients, he said a yearly echo is advised, and annual lung function testing is also useful.

“Pulmonary hypertension is really important in the life of the rheumatologist,” Prof Gaine told the Medical Independent.

“We share a lot of patients with our rheumatology colleagues around the country. The earlier we find people and get them on treatment, the better. The prognosis is improving – we can see that in our international cohorts that the patients are doing better, and it seems to be because they are being picked up earlier and treated earlier and we are seeing these better outcomes. We have new treatments coming down the line too, which are really exciting. It is a much better disease than it was 10-20 years ago.”