What Is Pulmonary Hypertension?
Pulmonary hypertension refers to high blood pressure in your pulmonary arteries. Your pulmonary arteries are the blood vessels that carry oxygen-poor blood from your heart to your lungs.
Pulmonary Hypertension vs. Hypertension
Pulmonary hypertension is a kind of high blood pressure, but it’s very different from hypertension in the rest of your blood vessels. High blood pressure throughout your body is known as systemic hypertension.
Systemic hypertension is when the force of your blood moving through your blood vessels is too high. Pulmonary hypertension is when the force of blood moving through the blood vessels in the lungs is too high. The difference is where the problem occurs in the body.
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Types of Pulmonary Hypertension
Pulmonary hypertension is a broad term because the condition can have many different causes. The World Health Organization classifies five types of pulmonary hypertension, based on the underlying cause:
Group 1—This is also known as pulmonary arterial hypertension (PAH). This type of pulmonary hypertension is rare. You may have inherited pulmonary hypertension. Or it may occur due to an autoimmune disease, an infection, or toxin exposure. One of the toxins that most commonly causes pulmonary hypertension is methamphetamine. A history of methamphetamine use increases your risk of pulmonary hypertension, even if you no longer use the substance. Some people also develop pulmonary hypertension for reasons that we do not understand (idiopathic pulmonary arterial hypertension).
Group 2—Heart disease affecting the left side of your heart, such as mitral valve disease, aortic valve disease, or heart failure causes this type. This is a more common cause of pulmonary hypertension.
Group 3—These types of pulmonary hypertension are caused by lung diseases such as chronic obstructive pulmonary disease (COPD) or interstitial lung disease. This type may also be caused by sleep apnea.
Group 4—You develop pulmonary hypertension because of chronic blood clots in the lungs.
Group 5—This group includes pulmonary hypertension caused by an assortment of conditions that don’t have a well-understood link. This includes conditions such as blood disorders, metabolic disorders, sarcoidosis, and vasculitis.
Pulmonary Hypertension Symptoms
You may notice that usual activities, such as climbing stairs or taking a walk, are suddenly difficult. Shortness of breath is the first sign of pulmonary hypertension for most people amongst other symptoms:
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Chest pain
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Fainting
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Fatigue
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Heart palpitations
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Leg swelling
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Abdominal distension
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Feeling full too quickly when eating
Unfortunately, by the time you experience symptoms, pulmonary hypertension is in later stages. As soon as you notice any small changes, see your health care provider immediately for an evaluation.
Does Pulmonary Hypertension Cause High Blood Pressure?
Pulmonary hypertension is a kind of high blood pressure affecting only your pulmonary arteries. But pulmonary hypertension does not cause systemic high blood pressure.
What Are the Stages of Pulmonary Hypertension?
Doctors determine your pulmonary hypertension stage based on your exercise capacity:
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Stage 1—You can complete all your usual activities without symptoms.
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Stage 2—You have mild limitations when participating in your usual activities.
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Stage 3—You notice a significant change in your ability to perform your usual activities.
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Stage 4—You can hardly do any physical activity without symptoms and may have symptoms at rest.
How Is Pulmonary Hypertension Diagnosed?
We will use several tests to diagnose pulmonary hypertension and find out more about the root cause:
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An electrocardiogram (EKG) checks your heart rhythm and looks for signs of an enlarged right heart ventricle.
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An echocardiogram is an ultrasound of the heart that looks at the function and size of the chambers of the heart and the function of the valves. This scan can also be used to estimate the pressure in your pulmonary arteries.
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Pulmonary function tests look at your lung capacity and how well your lungs exchange oxygen.
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A ventilation/perfusion (V/Q) scan measures how well oxygen and blood flow through your lungs and detects evidence of chronic blood clots.
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A right heart catheterization measures the pressure in your pulmonary arteries. This is the gold standard for diagnosis of pulmonary hypertension.
Pulmonary Hypertension Treatment
Treatment for pulmonary hypertension depends on the underlying cause of the condition:
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Continuous positive airway pressure (CPAP) to correct sleep apnea
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Medications to help your pulmonary arteries open
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Blood thinners and surgical or catheter-based procedures to remove blood clots
In advanced stages, you may need a lung transplant to treat pulmonary hypertension. We will only offer a lung transplant when you have exhausted all other treatments without success.
New Treatments for Pulmonary Hypertension
Doctors continually research new treatments for pulmonary hypertension. At University of Utah Health, our care team and patients participate in clinical trials for new and emerging pulmonary hypertension therapies.
Can Pulmonary Hypertension Be Reversed?
Most of the time, pulmonary hypertension is a chronic condition. Treatment may cure pulmonary hypertension if you have group 4 pulmonary hypertension caused by a blood clot. Sometimes treating sleep apnea can also cure pulmonary hypertension if that is the underlying cause
Living With Pulmonary Hypertension
Living with pulmonary hypertension can affect your overall function. Your provider will recommend what lifestyle or work-related adjustments to make.
Can I Work With Pulmonary Hypertension?
You may not be able to continue working your usual job or schedule, depending on the severity of pulmonary hypertension. Your employer may give you reasonable accommodations to continue working. Some people with pulmonary hypertension work part-time hours or pursue less intense jobs.
What Is the Best Sleeping Position for Pulmonary Hypertension?
There is no specific ideal sleeping position for individuals with pulmonary hypertension. The most important consideration for sleeping with pulmonary hypertension is finding a position that allows you to breathe comfortably and get a good night's rest. If you have specific medical devices or oxygen therapy prescribed for your pulmonary hypertension, make sure you follow your healthcare provider's instructions for their use during sleep.
Why Choose University of Utah Health?
Our Pulmonary Hypertension Clinic is one of only a few centers in the Mountain West region to achieve accreditation as a Center of Excellence with the Pulmonary Hypertension Association. We receive referrals from throughout and beyond our region, meaning other doctors trust us to take on the most complex cases.
Our team of pulmonologists and cardiologists work together to offer you comprehensive treatments, including through clinical trials. We coordinate all necessary tests and imaging in one appointment to make your visit as smooth and efficient as possible.
Schedule an Appointment
You will need a referral to visit the Pulmonary Hypertension Clinic. Your referring provider may call 801-585-7676 to request an appointment. One of our providers will review your referral before scheduling your visit.
