Pulmonary hypertension, the type of high blood pressure to watch out for: medications, symptoms, etc. & bull; hello healthy

High blood pressure or hypertension not only attacks the body as a whole, but can also affect the lungs. This disease is known as pulmonary or pulmonary hypertension. Although rare, this condition should not be underestimated. If you do not get proper treatment, the sufferer is at high risk of experiencing various complications of the disease. So, what is pulmonary hypertension?

What is pulmonary hypertension?

Pulomal hypertension or pulmonary hypertension is a type of high blood pressure that specifically affects the arteries in the lungs (pulmonary arteries) and the right chambers of the heart.

This condition occurs when the blood pressure in the pulmonary arteries is too high. The pulmonary arteries are blood vessels that carry less oxygenated and carbon dioxide-rich blood from the right ventricle of the heart to the lungs.

This increase in blood pressure occurs due to damage to the pulmonary arteries, which makes the pulmonary arteries narrow and stiff, so that the right ventricle of the heart stiffens and has to work harder to pump blood to the lungs. Over time, this condition can cause your heart muscle to become weak and lead to heart failure.

The difference between pulmonary hypertension and systemic hypertension

Pulmonary hypertension is different from ordinary hypertension, aka systemic hypertension. A cardiologist and pulmonary hypertension specialist from Yogyakarta Sardjito Hospital, dr. Lucia Kris Dinarti, Sp.PD, Sp.JP said, systemic hypertension is more related to the left ventricle of the heart, while pulmonary hypertension occurs in the right ventricle of the heart.

According to the American Heart Association, blood pressure in the lungs is lower than systemic blood pressure. Normal systemic blood pressure is in the range 90/60 mmHg - 120/80 mmHg, while normal blood pressure in the lungs is in the range of 8-20 mmHg at rest.

What are the signs and symptoms of pulmonary hypertension?

In general, the symptoms of ordinary hypertension with pulmonary hypertension are different. According to dr. Lucia Kris, the symptoms of pulmonary hypertension lead to more respiratory problems.

Shortness of breath or dizziness during activity are the first symptoms that usually appear. The heart rate can also be fast (palpitations). Over time, other symptoms appear when doing light activity or even when resting. Other symptoms include:

• Swelling in the feet and ankles.
• Bluish coloration of the lips or skin (cyanosis).
• Chest pain like pressure, usually in the front.
• Dizziness or even fainting.
• Fatigue.
• Increase in stomach size.
• Limp body.

"It is not easy to detect signs of pulmonary hypertension, because the symptoms are not unique and similar to other diseases. Even children are often misdiagnosed with TB disease. In fact, actually it could be pulmonary hypertension, "said dr. Lucia Kris, who also works closely with the Indonesian Pulmonary Hypertension Foundation (YHPI).

Apart from those mentioned above, there may be other symptoms and signs that you are feeling. If you have concerns about the symptoms of this disease, please consult your doctor.

What causes pulmonary hypertension?

The cause of pulmonary hypertension, namely a blockage or narrowing of the pulmonary arteries. In fact, the cause of the condition has never been clear. However, there are two factors that make a person usually develop pulmonary hypertension, namely genetics or heredity and certain medical conditions.

As for several medical conditions or diseases that can cause pulmonary hypertension, namely:

• Lung disease, such as emphysema, chronic bronchitis, pulmonary fibrosis, or pulmonary embolism.
• Kidney illness.
• Chronic kidney failure.
• Congenital heart defects or congenital narrowing of the pulmonary arteries from birth.
• Congestive heart failure or congestive heart failure (CHF).
• Left heart disease, such as left heart failure, ischemic heart disease, or heart valve disease, such as aortic stenosis and mitral valve disease.
• HIV.
• Liver disease, such as cirrhosis.
• Autoimmune diseases, such as lupus, scleroderma, arthritis or rheumatoid arthritis, and others.
• Sleep apnea.
• Metabolic disorders, such as thyroid disorders or Gaucher disease.
• Sarcoidosis.
• Parasitic infections, such as schistosomiasis or echinococcus, which are a type of tapeworm.
• Tumors in the lungs.

Risk factors

Pulmonary hypertension is a health condition that can occur in almost anyone. However, apart from genetics and certain medical conditions, there are several other factors that can increase a person's risk of developing this disease.

• Increasing age

Although it can be suffered by anyone, pulmonary hypertension is usually diagnosed in someone between 30-60 years of age.

• Gender

Pulmonary hypertension is more common in women than men. This is the same as heart failure which is more common in women.

• Lives in the highlands

Living in the highlands for years can make you prone to this disease.

• Obesity or overweight

Being obese or overweight can increase your risk of developing pulmonary hypertension.

• Take certain drugs

Some medications that can have an effect include weight loss drugs (fenfluramine and dexfenfluramine), chemotherapy drugs for cancer (dasatinib, mitomycin C, and cyclophosphamide), or selective antidepressant drugs serotonin reuptake inhibitors (SSRIs).

• Unhealthy habits or lifestyle

Some habits can increase the risk of pulmonary hypertension, such as the use of illegal drugs (cocaine and methamphetamine) and smoking.

What are the types of pulmonary hypertension?

Based on the cause, pulmonary hypertension can be divided into several types. The following is the division of types of pulmonary hypertension based on standards World Health Organization (WHO):

Group 1

Type 1 pulmonary hypertension is generally associated with problems with blood vessels. The following are the causes of pulmonary hypertension in group 1:

• The cause is not clear or is called idiopathic pulmonary hypertension. However, this condition is generally caused by genetics or heredity with the same disease.
• Take illegal drugs, such as methamphetamine.
• Congenital heart defects (congenital heart disease).
• Other conditions, such as autoimmune diseases (scleroderma and lupus), HIV infection, or chronic liver disease (cirrhosis).

Group 2

The causes of group 2 pulmonary hypertension are related to heart disease, especially those affecting the left side of the heart, such as:

• Heart valve disease, such as the mitral or aortic valve.
• Failure to function in the lower left part of the heart (left ventricle).
• Long-term high blood pressure.

Group 3

The causes of group 3 pulmonary hypertension are related to conditions that affect the lungs, such as:

• Chronic obstructive pulmonary disease (COPD)
• Emphysema
• Pulmonary fibrosis
• Sleep disturbance or sleep apnea
• Too long in a certain plateau or altitude

Group 4

The cause of group 4 pulmonary hypertension is associated with blood clotting disease. Whether it's blood clots in general or blood clots that only occur in the lungs (pulmonary embolism).

Group 5

Pulmonary hypertension in group 5 is often triggered by certain medical problems. Unfortunately, until now it is not known exactly why the various medical problems below can cause pulmonary hypertension.

• Blood disorders polycythemia vera and essential thrombocythemia.
• Systemic disorders such as sarcoidosis and vasculitis.
• Metabolic disorders such as thyroid and glycogen storage disease.
• Kidney illness.
• A tumor pressing on the pulmonary artery.

Eisenmenger syndrome

Eisenmenger syndrome is a type of congenital heart disease that can lead to pulmonary hypertension. This condition usually occurs because there is a hole between the two ventricles of the heart, which is called a ventricular septal defect.

How to diagnose pulmonary hypertension?

Pulmonary hypertension is difficult to diagnose at an early stage because it often goes undetected in routine physical examinations. Even as the disease progresses, the signs and symptoms are similar to those of other heart and lung diseases.

The doctor will perform several tests to make a correct diagnosis if you are suspected of having pulmonary hypertension. These tests include:

• Blood test.
• Right heart catheterization.
• Chest X-ray.
• CT scan of the chest.
• Echocardiography.
• Electrocardiography (EKG).
• Lung function tests.
• Lung scan.
• Pulmonary arteriogram.
• The test runs for six minutes.
• Sleep habits research.

What are the treatment options for pulmonary hypertension?

According to Prof. Dr. dr. Bambang Budi Siswanto, Sp.JP (K), FAsCC, FAPSC, FACC., Pulmonary hypertension expert from Harapan Kita Hospital, pulmonary hypertension is a disease that cannot be completely cured. Especially if it has entered a stage that is quite severe.

"This disease is not an independent condition, but a result of certain diseases. Therefore, the treatment that is carried out must be comprehensive, not only treat pulmonary hypertension, "said Prof. Bambang Budi.

The treatment given by doctors to patients with pulmonary hypertension aims to reduce the severity of symptoms, so that their condition remains stable in order to prolong life expectancy. Treatment for each person is different, depending on each condition.

Consult a doctor for the right treatment. Here are some treatments that doctors may give:

• Medicines, namely anticoagulants such as warfarin, vasodilator drugs to help loosen blood vessels, including other high blood pressure medications, such as calcium channel blockers and diuretics.
• Therapy, such as oxygen therapy.
• Pulmonary endarterectomy surgery.
• Other procedures, such as atrial septostomy or balloon pulmonary angioplasty (BPA).
• Lung or heart transplant.

Healthy lifestyle

To help extend life expectancy, apart from medical treatment from doctors, pulmonary hypertension patients also need to apply other things, including a healthy lifestyle. It is also important to prevent your pulmonary hypertension from getting worse, which can lead to other hypertensive complications.

• Plenty of rest.
• Stay active as much as possible.
• Do not smoke.
• Postpone pregnancy and don't use birth control pills.
• Avoid traveling to or living in the highlands.
• Avoid things that can excessively lower blood pressure, including long soaking in hot tubs or saunas.
• Avoid lifting heavy objects or weights.
• Find healthy ways to reduce stress, such as yoga, meditation, listening to music, or engaging in hobbies.
• Follow a hypertensive diet and maintain a healthy body weight.

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