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Short Communication - (2023) Volume 7, Issue 2

Development of Prognosticate Mortality in Hypertension and Genetic Markers
Norberto Brian*
 
Department of Neurosurgery, University of Louisville, Louisville, United States of America
 
*Correspondence: Norberto Brian, Department of Neurosurgery, University of Louisville, Louisville, United States of America, Email:

Received: 01-Mar-2023, Manuscript No. JCMS-23-21022; Editor assigned: 03-Mar-2023, Pre QC No. JCMS-23-21022(PQ); Reviewed: 17-Mar-2023, QC No. JCMS-23-21022; Revised: 24-Mar-2023, Manuscript No. JCMS-23-21022(R); Published: 31-Mar-2023, DOI: 10.35248/2593-9947.23.7.223

Description

Pulmonary Arterial Hypertension (PAH) is a progressive and lifethreatening disease characterized by increased blood pressure in the arteries of the lungs. It affects people of all ages and genders, but is most common in women between the ages of 30 and 60. PAH is a rare disease, with an estimated prevalence of 15-50 cases per million people worldwide. Despite advances in treatment over the past few decades, PAH remains a serious and challenging disease to manage, with a poor prognosis if left untreated [1]. Clinical trials are a critical component of developing new treatments for PAH, and have played a significant role in improving outcomes for patients. The evolving landscape of PAH clinical trials reflects advances in understanding the pathophysiology of the disease, as well as the development of new therapies that target specific molecular pathways [2].

Historically, PAH clinical trials focused on evaluating the efficacy of vasodilators, such as calcium channel blockers, prostacyclin analogues, and endothelin receptor antagonists [3-5]. While these therapies have been successful in improving symptoms and slowing disease progression in some patients, there is still a need for more effective and targeted treatments. In recent years, there has been a shift towards developing therapies that target specific molecular pathways involved in the pathogenesis of PAH. For example, studies have shown that abnormalities in the Nitric Oxide-Cyclic Guanosine Monophosphate (NO-cGMP) pathway are present in PAH, leading to decreased vasodilation and increased vasoconstriction. This has led to the development of drugs that target this pathway, such as riociguat, a soluble guanylate cyclase stimulator that increases cGMP levels and promotes vasodilation [6-9].

Another important pathway in the pathogenesis of PAH is the endothelia system. Endothelin-1 is a potent vasoconstrictor that is elevated in patients with PAH, leading to increased pulmonary vascular resistance and right ventricular hypertrophy. Endothelia receptor antagonists, such as bosentan and ambrisentan, have been developed to block the effects of endothelin-1 and improve symptoms in PAH patients. In addition to these targeted therapies, there has been a growing interest in combination therapies for PAH. The use of multiple therapies with different mechanisms of action can lead to synergistic effects and improved outcomes for patients. For example, the AMBITION trial compared the efficacy of ambrisentan and tadalafil, two drugs with different mechanisms of action, to monotherapy with either drug alone. The combination therapy was shown to be superior to monotherapy in improving exercise capacity and reducing clinical worsening [10]. The evolving landscape of PAH clinical trials also includes a focus on identifying biomarkers that can predict disease progression and treatment response. Biomarkers are objective measures of disease activity or treatment effect that can be used to guide treatment decisions and monitor disease progression.

Conclusion

For example, studies have shown that levels of Brain Natriuretic Peptide (BNP) and N-terminal Pro-BNP (NT-proBNP) are elevated in PAH patients, and can be used as markers of disease severity and prognosis. In addition, genetic markers, such as mutations in the Bone Morphogenetic Protein Receptor Type 2 (BMPR2) gene, have been identified as risk factors for developing PAH. The use of innovative trial designs is also an important aspect of the evolving landscape of PAH clinical trials. Adaptive designs, for example, allow for modifications to the trial protocol based on interim analyses of the data, which can lead to more efficient and informative trials. In addition, the use of patient-reported outcomes and digital health technologies, such as wearable devices and smartphone apps, can provide valuable data on disease progression and treatment response in real time.

References

Citation: Brian N (2023) Development of Prognosticate Mortality in Hypertension and Genetic Markers. J Clin Med Sci. 7:223.

Copyright: © 2023 Brian N. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.