These key learning points summarize the consensus- and evidence-based recommendations included in this edition. The sources listed here for each statement recommend that physicians perform or implement these actions directly in a clinical setting. A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patientoriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort.

1. High-dose calcium channel blockers should be prescribed for patients with idiopathic, heritable, or drug/toxin-associated pulmonary arterial hypertension with World Health Organization functional class I or II who demonstrate marked hemodynamic improvement (ie, mean pulmonary artery pressure less than 30 mm Hg and pulmonary vascular resistance less than 4 WU.)
Evidence rating: B
Source: Section One, Reference 2

2. Patients with pulmonary hypertension who are pregnant or considering pregnancy should receive prompt, multidisciplinary counseling at a specialized pulmonary hypertension center. This should include consultation with perinatology, genetic counseling, and shared decision-making to assess maternal and fetal risks. Psychological support should also be offered, regardless of whether pregnancy continuation or termination is pursued. Additionally, comprehensive contraception counseling should be offered when appropriate to support informed reproductive choices and prevent unintended pregnancies.
Evidence rating: B
Source: Section One, Reference 28