Raj Parikh, MD
The term hypertension is often used to describe high blood pressure. However, pulmonary hypertension (PH) is a chronic and progressive disease which describes high blood pressure in the lungs causing low levels of oxygen in the blood.
The following will provide more information on the possible causes, symptoms, and treatment options for PH. There is no cure, so appropriate medical treatment is key to managing the disease.
According to the World Health Organization, PH is classified into five groups based on different causes. The most common is PH due to left heart disease which comprises 68% of those diagnosed (source-Pulmonary Hypertension Association). In all cases, PH is a very serious condition and if left untreated can result in heart failure or death.
Based on information provided by the American Lung Association, common symptoms associated with PH include shortness of breath, fatigue, chest pain, heart palpitations, light-headedness/fainting, or edema – swelling from fluid retention in the ankles, legs, or abdomen. Some symptoms may be moderate or can cause great difficulty in carrying out normal activities of daily living. Additionally, early diagnosis can also be challenging as a person may not experience any noticeable changes in symptoms because of pre-existing medical conditions.
The causes of PH include congestive heart failure, blood clot in the lungs, illegal drug use, liver disease, autoimmune diseases, lung disease, HIV, or sleep apnea. In some cases, the origin may be genetic, environmental, or unknown. Young children with congenital heart defects are also vulnerable to PH.
Raj Parikh, MD, MPH, is a Pulmonary, Critical Care and Pulmonary Vascular Disease Specialist at Hartford Hospital and leads the Advanced Pulmonary Program at Riverside Health & Rehabilitation Center, an affiliate of the National Health Care Associates Inc. network. “Pulmonary hypertension is rare in the sense that it is often overlooked,” said Dr. Parikh. “The most commonly missed etiologies of PH include Scleroderma, a type of autoimmune disease, and blood clots in the lungs. Certain diseases such as HIV, liver disease and autoimmune diseases require frequent screening for PH given they are such prominent risk factors.”
When there is concern that a patient may have PH, it is important to have an expert or pulmonologist with a specialty in PH review medical history, symptoms and decide if additional testing is needed to determine diagnosis.
Based on the type of PH identified, medication options may include but are not limited to oxygen, diuretics, blood thinning medications, or calcium channel blockers to help lower blood pressure in the lungs. More aggressive therapies to open up the blood vessels can come in a variety of forms including a pill, inhaler or IV pump. In severe cases and where qualified, a lung transplant may be needed.
For a comprehensive reference on PH, including resources on local providers, please visit the Pulmonary Hypertension Association at www.phaassociation.org.
The key to maximizing quality of life involves maintaining a healthy diet, exercise and finding the appropriate physician and treatments.