Pulmonary hypertension is a serious but often underrecognized progressive condition characterized by abnormally high pressure in the blood vessels of the lungs. Over time, this increased pressure forces the right side of the heart to work harder to pump blood through the lungs.

Without appropriate treatment, pulmonary hypertension can lead to right-sided heart failure and other serious complications. INTEGRIS Health encourages Oklahomans to recognize the signs and symptoms, understand their risk factors and seek medical evaluation if symptoms develop.

"Pulmonary hypertension is different from the high blood pressure measured during a routine doctor's visit," explains John Kingrey, M.D., director of the INTEGRIS Health Pulmonary Hypertension Center with the INTEGRIS Health Heart Hospital. "It affects the blood vessels in the lungs and can be difficult to recognize because its symptoms often develop gradually and resemble those of many other heart and lung conditions. Early diagnosis gives patients the best opportunity for effective treatment and improved quality of life."

What Causes Pulmonary Hypertension?

Pulmonary hypertension develops when the blood vessels in the lungs become narrowed, blocked, damaged or otherwise unable to accommodate normal blood flow. As pressure builds, the right side of the heart must work harder to pump blood through the lungs.

There are several types of pulmonary hypertension, with causes that may include:

• Diseases affecting the left side of the heart
• Chronic lung diseases such as COPD or pulmonary fibrosis
• Chronic blood clots in the lungs (chronic thromboembolic pulmonary hypertension)
• Connective tissue diseases, including scleroderma and lupus
• Congenital heart disease
• Liver disease
• Sleep apnea and other sleep-related breathing disorders
• Certain medications or recreational drug use
• Pulmonary arterial hypertension (PAH), a less common form of pulmonary hypertension that may be inherited, associated with other medical conditions or occur without a known cause (idiopathic PAH)

Signs and Symptoms

Symptoms often begin gradually and may worsen over time. Common signs include

• Shortness of breath during activity or at rest
• Fatigue
• Chest pain or pressure
• Dizziness or fainting
• Rapid heartbeat or heart palpitations
• Swelling in the ankles, legs or abdomen
• Bluish lips or skin caused by reduced oxygen levels

Because these symptoms can occur with many heart and lung conditions, anyone experiencing persistent or worsening symptoms should seek medical evaluation.

"Many patients assume they're simply getting older or out of shape when they notice increasing shortness of breath," says Kingrey. "Persistent symptoms should never be ignored. A thorough evaluation can determine whether pulmonary hypertension or another condition is responsible."

Who Is Most at Risk?

Although pulmonary hypertension is relatively uncommon, certain factors increase the likelihood of developing the condition. Individuals at higher risk include those who:

• Have chronic heart or lung disease
• Have a family history of pulmonary arterial hypertension
• Have connective tissue diseases such as scleroderma
• Have chronic liver disease
• Have experienced recurrent blood clots in the lungs
• Have sleep apnea
• Use certain appetite suppressants or stimulant drugs

Women are more likely than men to develop certain forms of pulmonary arterial hypertension, although pulmonary hypertension affects people of all ages and both sexes.

Treatment Options

Although pulmonary hypertension does not have a universal cure, advances in treatment can slow disease progression, improve symptoms and enhance quality of life. Treatment is individualized based on the underlying cause and severity of the condition.

Treatment options may include:

• Medications that relax and widen the blood vessels in the lungs
• Blood thinners for selected patients
• Diuretics to reduce fluid buildup
• Oxygen therapy
• Pulmonary rehabilitation
• Treatment of underlying heart or lung conditions
• Lifestyle measures, including supervised exercise when appropriate, smoking cessation and maintaining a heart-healthy diet
• Advanced therapies or lung transplantation for carefully selected patients with severe disease

"Treatment for pulmonary hypertension has advanced significantly over the past two decades," states Kingrey. "Today, we have more therapies than ever before that can help patients remain active, reduce symptoms and improve long-term outcomes. The key is identifying the condition before irreversible damage occurs."

When to Seek Medical Care

Anyone experiencing unexplained shortness of breath, persistent fatigue, chest discomfort, fainting episodes or swelling in the legs should discuss their symptoms with a healthcare provider. While these symptoms often have causes other than pulmonary hypertension, early evaluation can identify the underlying condition and allow treatment to begin as soon as possible.

For more information about pulmonary hypertension or to schedule an appointment with a cardiovascular or pulmonary specialist at the INTEGRIS Health Heart Hospital, call 405-951-8523.