Pulmonary hypertension (PH) is a rare, life-threatening disease characterized by high blood pressure in the lungs due to damage to the pulmonary arteries. These vessels, which are responsible for transporting blood from the heart to the lungs, become narrowed and blocked due to the disease. Therefore, the heart needs to work harder to properly pump the blood, becoming enlarged and weakened. Patients are particularly at risk of developing other conditions and suffering right heart failure.
There is currently no cure for pulmonary hypertension, but there are treatments that can help ease the symptoms, slow the progression of the disease and improve patients’ quality of life. According to the National Heart, Lung and Blood Institute (NHLB) from the National Institutes of Health (NIH), PH is treated with medicines, procedures, and other therapies, which are prescribed based on the subtype of the disease diagnosed as well as its severity.
How to Treat Pulmonary Arterial Hypertension: Group 1
The group 1 defined by the World Health Organization (WHO) includes inherited or familial PH and idiopathic PH, which means that the cause for it is unknown, as well as PH caused by determined drugs or conditions. Medication is one of the courses of treatment for group 1 pulmonary arterial hypertension. The most common drugs are meant to relax the blood vessels in the lungs and reduce excess cell growth in the blood vessels. Medication, which can be taken orally, inhaled or injected, include phosphodiesterase-5 inhibitors such as sildenafil, prostanoids, such as epoprostenol, endothelin receptor antagonists, such as bosentan and ambrisentan, and calcium channel blockers, such as diltiazem.
Physicians can prescribe one or more medications, as well as request an acute vasoreactivity test to evaluate how the pressure in the pulmonary arteries reacts to prescribed drugs. In addition, the doctor may also recommend medical and surgical procedures. During an atrial septostomy (sep-TOS-toe-me), a catheter is placed through a blood vessel of the leg into the heart’s septum, which is the wall that separates the left and right atria. A tiny balloon on the tip of the tube is then inflated, creating an opening between the atria and relieving the pressure. While the atrial septostomy is a very rare procedure, lung transplants and heart-lung transplants are more common alternatives.
How to Treat Pulmonary Hypertension: Groups 2 and 3
Group 3 pulmonary hypertension includes cases of the disease caused by left-side diseases such as mitral valve disease. In order to treat patients in this group, physicians will focus on the treatment of the underlying condition with lifestyle changes, medicines, and surgery.
Similarly, cases in the group 3 pulmonary hypertension are caused by lung conditions like chronic obstructive pulmonary disease (COPD) and interstitial lung disease, or sleep disorders like sleep apnea. In addition to treating the underlying cause of the disease, physicians may also recommend oxygen therapy, a resource administrated through soft, plastic prongs that fir into the nose at home or in a hospital, to increase the level of oxygen in the blood.
How to Treat Pulmonary Hypertension: Groups 4 and 5
Group 4 pulmonary hypertension includes cases of the disease caused by blood clots in the lungs or blood clotting disorders. To treat this, patients are often prescribed blood-thinning medicines to prevent the formation or enlargement of clots. Surgery is also an option to remove scarring in the pulmonary arteries due to old blood clots. Group 5 pulmonary hypertension includes all other conditions that cause PH, such as thyroid disease and sarcoidosis, or an object, such as a tumor pressing on the pulmonary arteries. The treatment of patients in this group is conducted by treating the underlying cause.
Treatments Used in All Types of Pulmonary Hypertension
In addition to the personalized treatments for each group, there are also numerous treatments that can be applied to all types of pulmonary hypertension. These include diuretics, or water pills, which help reduce fluid buildup in the body, such as swelling in the ankles or feet. Blood-thinning medicines are used to avoid blood clots, while digoxin improves heart beat strength, helping it pump more blood, as well as to control the heart rate in the case of abnormal heart rhythms, such as atrial fibrillation or atrial flutter.
Physicians may also recommend oxygen therapy to increase the levels of oxygen in the blood, as well as lifestyle alterations and moderated physical activity to improve patients’ ability to be active. Researchers worldwide are currently working to improve pulmonary hypertension treatments, and find a cure for the disease.
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