Scientific and practical silhouettes of pulmonary hypertension (message one)

ABSTRACT. The historical development of understanding pulmonary hypertension (PH) demonstrates the evolution from descriptive morphology to precise molecular medicine, resulting in the creation of effective therapeutic strategies for a previously fatal disease. Key scientific publications, clinical trials, and historical milestones in the study of PH for the period 1886-2020 were reviewed. Six major stages in the development of knowledge about PH such as early morphological descriptions (1886-1891), the formation of clinical concepts (1901-1938), the development of diagnostic methods (1930-1970), epidemiological studies and classification (1965-1980), molecular discoveries (1980-2000), and modern targeted therapy (2000 – present) were identified. Among key milestones, there were the first clinical description by Romberg (1891), the epidemic due to taking aminorex (1965-1968), the use of cardiac catheterization with the Forssmann – Cournand – Richards technique (1929-1944), and the discovery of the role of nitric oxide (1980-1987). The transformation from descriptive pathology to molecular understanding has led to the creation of three major therapeutic classes: prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors.