Pulmonary Hypertension

Pulmonary hypertension (PH) is a general diagnosis that means you have high blood pressure in your pulmonary arteries. These are the blood vessels that carry oxygen-poor blood from your heart to your lungs.

Pulmonary hypertension has many different causes. It’s usually a complication of heart disease or lung disease. But many other diseases and environmental factors can raise your risk for PH.

Pulmonary hypertension is dangerous because it disrupts the flow of blood through your heart and lungs. High blood pressure in your pulmonary arteries causes these arteries to become narrow. As a result, your heart must work harder to pump oxygen-poor blood to your lungs.

Over time, PH damages your heart and causes problems throughout your body. It can be fatal without treatment.

How does pulmonary hypertension affect my body?

Pulmonary hypertension can cause serious problems in your body, including:

• Anemia.
• Arrhythmias.
• Blood clots in your pulmonary arteries.
• Pericardial effusion.

PH is dangerous for people who are pregnant. It can cause complications for both the birthing parent and fetus.

Without treatment, pulmonary hypertension can overtax your heart and eventually be fatal. High blood pressure in your pulmonary arteries forces your heart to work harder to send oxygen-poor blood to your lungs. Your right ventricle (lower right chamber) is responsible for pumping this blood to your lungs. So, over time, PH causes your right ventricle to get bigger due to the extra work. This condition (right ventricular hypertrophy) can lead to right-sided heart failure.

Right-sided heart failure has a ripple effect throughout your body. It can disrupt the normal workings of many organs and systems.

Because pulmonary hypertension can affect your entire body, it’s essential that you’re diagnosed and treated as early as possible. Your provider will prescribe treatment based on what’s causing your PH. No matter the cause, untreated PH is life-threatening.

What are the different types of pulmonary hypertension?

The World Health Organization (WHO) divides pulmonary hypertension into five groups based on its cause.

• Group 1 PH due to pulmonary arterial hypertension (PAH). PAH has many different causes, ranging from underlying diseases to certain drugs. PAH makes your pulmonary arteries become narrow, thick or stiff. Less blood can flow through, which raises the pressure in your pulmonary arteries.
• Group 2 PH due to left-sided heart disease. The left side of your heart pumps out blood to your entire body. If there’s a problem on this side of your heart, it affects the right side of your heart and your entire pulmonary circuit. Blood backs up in your heart, raising the pressure in your pulmonary arteries.
• Group 3 PH due to lung disease or hypoxia. Certain lung problems cause the arteries in your lungs to tighten. Less blood can flow through your lungs, raising the pressure in your pulmonary arteries.
• Group 4 PH due to blockages in your lungs. Blood clots or scars from blood clots prevent your blood from flowing normally through your lungs. This puts more stress on the right side of your heart and raises pulmonary blood pressure.
• Group 5 PH due to other disorders. PH occurs along with other conditions like blood disorders and metabolic disorders. The exact mechanisms for how the condition triggers PH aren’t always clear.

Who does pulmonary hypertension affect?

Pulmonary hypertension can affect adults at any age. It commonly affects people who have heart or lung conditions. It’s also more common among people with other medical conditions. PH affects:

• Nearly 100% of people with severe mitral valve disease.
• About 65% of people with aortic valve disease.
• Up to 30% of people with scleroderma.
• About 20% to 40% of people with sickle cell disease.
• About 1 in 200 people with HIV.

PH usually affects adults. But rarely, it can affect newborns. This is called persistent pulmonary hypertension of the newborn (PPHN). Infants with this condition may need treatment in the intensive care unit.

How common is pulmonary hypertension?

Some types of PH are rare, such as pulmonary arterial hypertension (PAH) and PH caused by blood clots. But other types are much more common, especially PH caused by heart or lung problems.

We don’t know exactly how many people around the world have pulmonary hypertension. But some estimates show PH may affect 1 in 100 people. This means 50 million to 70 million people are living with PH.

PH is even more common among older adults. Around the world, about 1 in 10 adults over age 65 have PH.

Researchers believe the number of people diagnosed with PH will rise in the next few decades.