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CME: Keeping the pressure down: optimizing our approaches to managing pulmonary arterial hypertension (PAH)

Activity Description / Statement of Need:

In this online, self-learning activity:

Pulmonary hypertension (PH) comprises five etiologic groups; Group I, pulmonary arterial hypertension (PAH), is a precapillary entity defined hemodynamically by right‑heart catheterization: mean pulmonary artery pressure >20 mm Hg, pulmonary artery wedge pressure ≤15 mm Hg, and pulmonary vascular resistance ≥3 Wood units. PAH is uncommon but consequential; estimates place U.S. prevalence near 10.6 per million, with contemporary data showing rarity yet meaningful population burden. Sex differences are notable—women predominate, while men may experience more severe trajectories—underscoring the need for sex‑aware assessment. Multinational reviews suggest incidence and prevalence remain non‑trivial, with enduring morbidity and mortality despite therapeutic gains.

Target Audience:

HCPs including but not limited to: pulmonology, cardiology, and primary care; physician assistants, nurse practitioners, and pharmacists who practice in the aforementioned areas of specialty; and any other healthcare professionals with an interest in or who clinically encounter patients with PH.


Commercial Support Disclosure: This program is supported by educational grants from Mallinckrodt and Merck. 

This activity is free of charge.


Release Date: January 27, 2026 -- Expiration Date: January 27, 2028

Faculty: Zeenat Safdar, MD

Agenda

Introduction, disclosures

Introductory content of PAH I: definitions, classifications, and risk

  • Review of hemodynamics and right heart parameters 
  • Differential by PH group; common mimics and exclusion steps 
  • Epidemiology: incidence and increasing prevalence in the U.S. 
  • When echo findings should accelerate consideration of right heart catheterization or therapy escalation 
  • Risk assessment
      • Aligning ESC/ERS variables with REVEAL-style domains
      • Serial reassessment at healthcare visits

Treatment of PAH Group I

  • When and how to escalate 
    • Clear thresholds for adding parenteral prostacyclin; inpatient vs outpatient initiation 
    • Dose titration, line care, and monitoring for dose-limiting AEs
    • Communicating goals-of-therapy and expected time course of benefit
    • Beyond vasodilation 
      • BMP/activin pathway rationale; eligibility and contraindications
      • Expected deltas (6MWD, PVR, NT-proBNP) and typical timelines
      • Lab/echo follow-up cadence; positioning with existing regimens
  • Novel agents
  • Challenges and solutions
  • Closing delay and misclassification
      • Primary care cues for early suspicion; clean handoffs between cardiology and pulmonology
      • Standardized referral pathways to PH centers; what information to send, and when
      • “Red-flag” escalation protocols.
  • Longitudinal care model
      • Team roles, including nursing, pharmacy, and rehabilitation
      • PROs and adherence tools; iron assessment/correction; vaccination and comorbidity management
      • Shared decision-making aids for therapy choices, including fixed-dose combinations and parenteral initiation
  • Patient case(s) 

Summary, conclusion, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall contemporary hemodynamic definition and PH classification.
  • Describe appropriate first-line testing and structured risk tools for PAH.
  • Choose evidence-based, risk-aligned therapy to treat PAH.
  • Explain how vascular and right ventricular remodeling pathways drive disease progression and inform the rationale for multi-pathway and emerging therapies in PAH.
  • Discuss challenges to the optimal management of PAH and the value of risk reassessment, early referral to PH centers, and multidisciplinary coordination.

Accreditation

ACCME Activity #203391897

ScientiaCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours  of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-26-011-H01-P. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurses: This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™, and the American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credit(s)™ to meet the continuing education renewal requirements of nursing re-certification for APRNs and RN specialty. Some state nursing boards accept AMA PRA Category 1 Credit(s)™ for re-licensure requirements, some do not. Check your state board of nursing's CE requirements before applying credit from this course to your re-licensure.

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts AMA PRA Category 1 Credit™ assigned by organizations accredited by the ACCME as satisfying Category 1 CME for National Commission on Certification of Physician Assistants (NCCPA) national certification maintenance. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Board (AANPCB) states that continuing education providers accredited by the ACCME may provide acceptable, accredited Advanced Practice Provider content. This activity is designated for up to 1.0 AMA PRA Category 1 Credit(s)™.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Disclosures of Faculty: Zeenat Safdar, MD, Professor of Medicine, Houston Methodist Research Institute, has received financial compensation from United Therapeutics, Johnson & Johnson (Actelion), Boehringer Ingelheim, Merck, and Insmed for consulting services; in addition to speaker’s bureau work from United Therapeutics, Johnson & Johnson (Actelion) and Boehringer Ingelheim.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.  

Faculty WILL NOT discuss off-label uses of a commercial product. 

All relevant financial relationships have been mitigated. 

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Mallinckrodt and Merck. 

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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