Expert consensus on the stratification, management, and follow-up of patients with Group 1 pulmonary hypertension at intermediate risk

Abstract

Introduction: stratification of risk for major complications (including mortality) is the current fundamental clinical strategy for making therapeutic decisions in patients with pulmonary arterial hypertension. However, it is noticeable that most patients are grouped in the intermediate category both at the time of diagnosis and during follow-up, highlighting the relevance and necessity of improving discrimination and therapeutic options for patients at intermediate risk. Objective: to define a series of recommendations on the proper subclassification, follow-up, and treatment of adult patients with pulmonary arterial hypertension at intermediate risk, adapted to the Colombian context. Method: fifteen experts in pulmonary hypertension were invited to participate. They voted on 14 questions, using the modified Delphi methodology, and a systematic review of the literature on these questions was carried out in several bibliographic bases: VHL, Cochrane Library, PubMed, Medline and Web of Science. The MeSh and DeCs criteria for each question were used without language or time limits. Results and discussion: the present study provides a series of 18 consensus recommendations on stratification, treatment and other sections. Additionally, the initiative shows the paucity of scientific studies in our country to identify the behavior of this disease along with the barriers to access and availability of medicines in our country.