Guest editors' memo
Citation: Advances in Pulmonary Hypertension 10, 3; 10.21693/1933-088X-10.3.142
Citation: Advances in Pulmonary Hypertension 10, 3; 10.21693/1933-088X-10.3.142
Although pulmonary hypertension is not a uniquely female problem, women living with pulmonary hypertension often have female-specific concerns; such as, whether they should get pregnant; what types of contraception are safe and effective in PH; and whether routine health-maintenance care and exams are necessary. Separately, the increased incidence and prevalence of pulmonary hypertension in women vs men has led to considerable discussion over the years as to the role for sex hormones in the pulmonary vasculature and in the development of pulmonary hypertension.
It is, therefore, with great pleasure that we present this issue of Advances in Pulmonary Hypertension in which “Women's Issues” are discussed from both perspectives. Dr Austin's article, “Gender, Sex Hormones, and Pulmonary Arterial Hypertension” starts off with a comparison of the female:male gender ratios in pulmonary hypertension as shown in large observational studies such as the REVEAL registry. He follows this with a presentation of the evidence for and against a connection between sex hormones and pulmonary hypertension, ending with an overview of his own very interesting work looking at whether certain estrogen metabolites are associated with familial forms of PH.
Dr Munoz-Santiago, a maternal-fetal medicine specialist, writes on “Contraceptive Options for the Patient with Pulmonary Arterial Hypertension.” Her review reminds us of the highly concerning maternal and fetal morbidity and mortality that are seen even in recent pulmonary hypertension case series, and provides a strong rationale for encouraging the use of highly-effective birth control in all women with pulmonary hypertension.
Next, because some patients with pulmonary hypertension may become pregnant despite medical advice, or present during pregnancy, our last article focuses on cardiopulmonary physiology during a normal pregnancy and the changes seen in PH. This is then followed by a roundtable discussion on the care for patients with PAH during a pregnancy.
Finally, so as not to ignore the men completely in this issue, Dr Williamson discusses two “Men's Issues” in his guest coverage of the Ask the Expert column.