Pulmonary Hypertension: A Lesser-Known, Greater-Risk form of High Blood Pressure
May 4, 2017
Pulmonary hypertension needs to be specially treated.
Most people know the term hypertension as a synonym for high blood pressure, specifically measuring the force of blood moving through the body’s blood vessels. Less people know that high blood pressure can be centralized in the heart-to-lung system, indicating an excessive force needed to pump blood through the pulmonary arteries. This is called pulmonary hypertension.
The pulmonary arteries are the channels that send oxygen-depleted blood from the heart to the lungs where the blood can become oxygen-rich again. Nearly every movement and process within our bodies relies on the oxygen in our blood to function, so this is an extremely important physiological process.
When the body is at rest, a normal level of pressure in the pulmonary artery is 8-20 mm Hg. When the arteries in the lungs have narrowed or thickened, as with pulmonary arterial hypertension, the blood flow slows and more pressure is needed to pump the blood through the channel. Increased pressure that surpasses 25 mm Hg at rest is considered pulmonary hypertension.
“In a narrowed artery, or in an artery in which the lining has thickened, you see a resistance to blood flow,” says Maria Hymon, RN, MSN, ACNP. “As the heart is tries to pump the blood through a smaller area, a back-up can build. As the pressure increases, the back-up can extend into the right side of the heart, which eventually causes heart failure.”
Having to continually work harder to force the blood through the arteries can weaken the heart muscle over time.
One of the challenges with pulmonary hypertension is that its symptoms are the same as those seen for many other conditions, and they often develop slowly.
Early signs of pulmonary hypertension include:
- Shortness of breath during routine activity
- Chest pain
- Racing heartbeat
- Pain in upper right side of abdomen
- Decreased appetite
More advanced symptoms include:
- Feeling light-headed, especially during physical activity
- Swelling in the ankles or legs
- Bluish lips or skin
“The most common symptom, though, is the shortness of breath, so the mean average time for pulmonary hypertension diagnosis is about three years because physicians will work to rule out the more common conditions first,” says Hymon.
A specific type of pulmonary hypertension in which the disease process occurs in the pulmonary arteries themselves is called pulmonary arterial hypertension. This condition generally affects young and otherwise healthy individuals and strikes women twice as frequently as men. The average age of diagnosis is 36 years.
If someone experiencing these symptoms has ruled out other considerations, they should discuss the possibility of pulmonary hypertension with their doctor. Since, at that point it would be likely that an echocardiograph, chest X-ray, and electrocardiogram (EKG) had been used to look for other concerns, a pulmonary artery catheterization (also called a “right-heart cath”) would likely be used to determine if pulmonary arterial hypertension is present.
While pulmonary hypertension has no cure, you can live an active life by working with a specialist to manage your symptoms. “We have patients who have been on treatment for six or seven years and they are doing great,” says Hymon.
The Word Health Organization has established five different groups of pulmonary hypertension, and within these groups there is a range of severity and effects, so each pulmonary hypertension patient case is different.
It’s important to work with a specialist so that you can be sure to receive the best care for your needs.
Providence Health has offices that specialize in pulmonary care in downtown Columbia and in Lexington, as well as a rehabilitation center that is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR).
Maria Hymon, RN, MSN is a pulmonary specialist trained as an NP practicing at Providence Midlands Pulmonary, Critical Care & Sleep Medicine.