Anticoagulation is the term to describe treatments used to help prevent blood clots from forming in blood vessels. Anticoagulation is a conventional therapy used to treat some people with pulmonary hypertension (PH). It will be prescribed life-long for people who are at higher risk of developing blood clots, for example patients with chronic thrombo-embolic pulmonary hypertension (CTEPH). It will also be recommended for patients suffering from problems of irregular heartbeats, for example atrial fibrillation (AF). The place in therapy of anticoagulation for other PH patients is decided on an individual basis. This clinical decision involves weighing up the potential benefits against risks.
Historically, the most commonly prescribed anticoagulant was warfarin. More recently alternatives have been approved and are increasingly used: rivaroxaban, apixaban, edoxaban and dabigatran, collectively known as either NOACs (Novel Oral Anticoagulants) or DOACs (Direct Oral Anticoagulants). These have also been shown to be safe and effective in preventing and treating blood clots. At this time, there are no large trials in PH, but there is no reason to suspect they are less effective than warfarin.