Expert opinion on pharmacotherapy
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Despite an increasingly older pulmonary hypertension (PH) population, data on PH treatments in these patients are limited because there exist no clinical studies dedicated to geriatric groups. Furthermore, elderly patients with comorbidities have been systematically excluded from clinical trials, limiting the evidence base for drugs approved for pulmonary arterial hypertension (PAH). ⋯ Current data indicate that despite more severe disease in elderly patients, the concept of hit hard and early is less used. For example, double upfront oral combination, a common strategy for younger patients, or early parenteral prostacyclins, are less used in the elderly, purporting worse outcomes for these patients.