You may know what hypertension is, but have you heard of pulmonary hypertension? Most people have not.
High blood pressure, also called hypertension, is very common. According to the Centers for Disease Control and Prevention, nearly half of adults in the U.S. have high blood pressure.
Pulmonary hypertension is different. It is high blood pressure in the blood vessels of the lungs. It is rare, affecting about 1% of people worldwide, but it can be serious.
Dr. Rodolfo Estrada Anzueto, a pulmonary disease specialist with the Pulmonary Hypertension Program at University Health, explains what pulmonary hypertension is and which symptoms to watch for.
What Is Pulmonary Hypertension?
This form of high blood pressure affects the blood vessels in the lungs. “When blood pressure in the lungs is higher than normal, it causes the heart to work harder to pump blood into the lungs,” Dr. Estrada said. “Over time, that can damage the heart.”
Pulmonary hypertension can happen when arteries in the lungs become narrow. When that happens, the right side of the heart has to work harder to move blood through the lungs. Over time, this can weaken the heart.
Normal vs. High Pulmonary Blood Pressure
Pulmonary blood pressure is much lower than regular blood pressure measured in the arm.
The average pulmonary artery pressure is 11 to 20 millimeters of mercury, or mm Hg, when the heart is at rest. A reading higher than 20 mm Hg is considered pulmonary hypertension.
What Causes Pulmonary Hypertension?
High blood pressure in the pulmonary arteries can happen on its own or be caused by another health condition. According to the National Heart, Lung, and Blood Institute, more than half of pulmonary hypertension cases have no known cause.
In the U.S., the main cause is left-sided heart disease, such as heart failure.
When the left side of the heart is weak, it may have trouble pumping oxygen-rich blood to the body. Blood can back up into the lungs and lead to changes that cause pulmonary hypertension.
Pulmonary hypertension may also be caused by long-term lung disease, other types of heart disease, blood clots in the lungs or, rarely, problems with the walls of the blood vessels.
Risk Factors for Pulmonary Hypertension
Anyone can develop pulmonary hypertension, but some factors can raise your risk. These include:
- Certain genetic disorders
- Environmental exposures
- Family history of blood clots
- Some medicines used to treat cancer or help with weight loss
- Smoking or illegal drug use
“Pulmonary hypertension is more common among women than men, and it most often occurs in people between the ages of 30 and 60,” Dr. Estrada said. Less often, it can develop in children.
Pulmonary Hypertension Symptoms
Like regular high blood pressure, pulmonary hypertension can be “silent.” This means it may cause no symptoms at first. Symptoms may also be easy to mistake for other health problems.
Symptoms can include:
- Chest pain
- Coughing up blood
- Dizziness
- Dry cough
- Hoarseness
- Tiredness or weakness
- Nausea and vomiting
- Shortness of breath
- Swelling in the legs, feet or belly
- Wheezing
These symptoms may start slowly and get worse over time. If you have any of these symptoms often, tell a medical provider. If you have chest pain, seek emergency medical care.
Diagnosing Pulmonary Hypertension
Regular blood pressure is checked at most medical visits. Pulmonary hypertension is harder to check.
If you have lung or heart symptoms, such as wheezing, coughing, chest pain or swelling, your provider may recommend tests to check the pressure in your lungs.
An echocardiogram, or heart ultrasound, can help your provider look for signs of pulmonary hypertension. A right heart catheterization is used to confirm the diagnosis. During this test, a provider measures pressure inside the heart and pulmonary arteries. Pulmonary hypertension is diagnosed when mean pulmonary artery pressure is higher than 20 mm Hg.
Treating Pulmonary Hypertension
If you are diagnosed with pulmonary hypertension, your provider can create a treatment plan for you. Treatment may include:
- Lifestyle changes. Healthy eating habits and regular exercise can help lower overall blood pressure and support heart and lung health.
- Your provider may prescribe medicine to help prevent blood clots, control heart rate or lower blood pressure.
- Some people may need a procedure to lower pressure in the heart, open narrowed arteries or remove blood clots from the lungs.
Treatment may also include care for the condition causing pulmonary hypertension, such as left-sided heart failure.
Pulmonary Hypertension Care at University Health
Pulmonary hypertension can be serious, but expert care can make a difference.
At University Health, our Pulmonary Hypertension Program provides diagnosis, treatment and long-term care based on each patient’s needs. The program offers advanced care options, including in-hospital therapy for severe cases, infusion medications and mechanical support devices. The center also takes part in clinical trials to help provide leading care in the region.
For people with advanced disease, our nationally recognized lung transplant team performed the nation’s first lung transplant to treat pulmonary hypertension, offering hope when other treatment options are no longer enough.
For more information on our Pulmonary Hypertension Program, call us at 210-567-5777.
