What is the role of vasodilators in the treatment of cor pulmonale?

Updated: Dec 15, 2017
  • Author: Derek Leong, MD; Chief Editor: Henry H Ooi, MD, MRCPI  more...
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Answer

Answer

Vasodilators have been advocated in the long-term management of chronic cor pulmonale with modest results. Calcium channel blockers, particularly oral sustained-release nifedipine [26] and diltiazem, can lower pulmonary pressures, although these agents appear more effective in primary rather than secondary pulmonary hypertension. [27]

Other classes of vasodilators, such as beta agonists, nitrates, and angiotensin-converting enzyme (ACE) inhibitors have been tried but, in general, vasodilators have failed to show sustained benefit in patients with COPD, and they are not routinely used. A trial of vasodilator therapy may be considered only in patients with COPD with disproportionately high pulmonary hypertension.


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