Pulmonary hypertension is a life-threatening condition. Effective treatments are available for some types of pulmonary hypertension, but Deaño et al find that half of patients referred to pulmonary hypertension centers are referred late in the course, when treatment is unlikely to be effective. In addition, more than half of patients who had started receiving medications did not have the type of pulmonary hypertension that would be expected to respond to these medications. As these drugs have definite harms (liver failure, shock, edema) and no known benefit outside of group 1 pulmonary hypertension, we consider this a Less Is More article.
Redberg RF. Improving Care for Patients With Pulmonary HypertensionComment on “Referral of Patients With Pulmonary Hypertension Diagnoses to Tertiary Pulmonary Hypertension Centers: The Multicenter RePHerral Study”. JAMA Intern Med. 2013;173(10):893. doi:10.1001/jamainternmed.2013.783