There is often no cure for pulmonary hypertension. However, a doctor can prescribe treatments to manage the condition. Doctors will determine the cause of hypertension before forming a treatment plan.
The pulmonary artery
Treatments include medication, oxygen therapy, and surgery in some cases. Treatment aims to reduce symptoms, making the condition more manageable.
This article examines the different treatments for pulmonary hypertension, diagnosis, outlook, and more.
Around 50–70 million people worldwide, almost 1% of the global population, experience pulmonary hypertension.
Types of pulmonary hypertension, as defined by the World Health Organization, include:
- Group 1 – pulmonary arterial hypertension (PAH): With this condition, arteries in the lungs narrow. The right side of the heart compensates by working harder to push blood through these arteries.
- Group 2 – pulmonary hypertension due to left heart disease: Problems with the left side of the heart mean the heart cannot keep up with the rate of blood returning from the lungs. The excess blood increases artery pressure.
- Group 3 – pulmonary hypertension due to lung disease: Lung conditions such as emphysema lead to a low oxygen level. This causes the pulmonary artery to change and constrict, causing high blood pressure.
- Group 4 – chronic thromboembolic pulmonary hypertension (CTEPH): This is when a person’s body cannot dissolve a blood clot. This restricts blood flow in the lungs.
There is often no cure for pulmonary hypertension. However, many methods exist to help
It is important to detect symptoms of pulmonary hypertension early. This allows a doctor to create an effective treatment plan. A person should seek medical advice if they suspect they have this condition.
This article will describe the possible treatments a doctor may recommend to manage symptoms.
Doctors prescribe different medications to treat pulmonary hypertension, depending on the type a person has.
Anticoagulants
Anticoagulants, or blood thinners, help prevent the development of blood clots in the lungs.
They also treat a pulmonary embolism, a blood clot in the lungs that can cause pulmonary hypertension. Anticoagulant medications can help manage symptoms of CTEPH.
Side effects of anticoagulants can include:
- excessive bruising
- nosebleeds
- blood in the urine
- heavy menstrual bleeding
Diuretics
Diuretics are medications that remove water from the body. This decreases the amount of fluid in the blood vessels.
A doctor may prescribe this for group 2 pulmonary hypertension or people from any group who have right sided heart failure.
Side effects of diuretics can include:
- a decline in potassium (though some types, such as amiloride and triamterene,
do not cause this ) - gout
- increase in blood sugar if a person is diabetic
- erectile dysfunction
Digoxin
Digoxin can ease symptoms of pulmonary hypertension by strengthening heart contractions and reducing the heart rate. It does this by
Side effects of digoxin can include:
Digoxin is safe to take in very specific amounts approved by a doctor. If a person has any of the following conditions, they should avoid digoxin:
- myocarditis
- ventricular fibrillation
- Wolff-Parkinson-White syndrome
- allergy to digoxin or any of its ingredients
People with thyroid conditions should talk about this with a doctor before taking digoxin. In some cases, a doctor may recommend a different treatment option.
Other medical treatments
Other treatment options a doctor may recommend include:
- prostaglandins such as treprostinil and epoprostenol
- endothelin receptor antagonists such as ambrisentan, bosentan, and macitentan
- phosphodiesterase-5 inhibitors such as sildenafil, tadalafil, and vardenafil
- guanylate cyclase stimulators such as riociguat
A doctor may recommend a person who has PAH tries low dose oxygen therapy if they have a low blood oxygen level.
Supplementing breathing with oxygen helps to release carbon monoxide buildup in the lungs that occurs as a result of PAH.
A study from 2018 found that oxygen therapy significantly improved the outlook of people with severe pulmonary hypertension.
Doctors prescribe oxygen therapy at very specific dosages, as oxygen can be toxic. A person should only take prescribed oxygen exactly as a doctor has recommended.
Some people may require surgical treatment for pulmonary hypertension, which may include the following.
Pulmonary endarterectomy
This procedure removes blood clots from people with CTEPH.
This surgery typically has positive long-term results, and most people experience a reduction in symptoms and an improved outlook after the procedure. It is one of the only treatments for pulmonary hypertension that may be able to cure the condition.
However, some people may not be able to have the surgery. A person should discuss their eligibility with a doctor.
The main risk associated with this surgery is postoperative right heart failure. This is more prevalent in those who had more severe conditions before surgery.
Balloon pulmonary angioplasty
This procedure involves inserting a small balloon into the artery and inflating it temporarily. This allows doctors to move a clot and restore blood flow.
This procedure may improve the quality of life of a person with pulmonary hypertension.
However, people may experience complications, such as:
- damage to the artery
- allergic reaction
- excessive bleeding
- stroke
- heart attack
Atrial septostomy
This procedure creates a small hole in the wall
This procedure is a temporary fix, and doctors typically only recommend it when the person is awaiting a transplant.
Risks can include:
- heart rhythm disturbance
- injury to veins
- arrhythmia
Transplant
People with severe conditions may need a lung or heart transplant. However, transplants are not common, as there are other effective treatments available.
As with all transplant surgeries, organ rejection is a risk.
A doctor will focus on treating the cause of a person’s hypertension. If heart or lung conditions are causing it, a doctor will prioritize treating those. For example, a doctor will prescribe anticoagulants for a person with CTEPH.
If a doctor recommends them, the following lifestyle changes may help to ease symptoms and prevent condition progression:
- quitting smoking, if applicable
- exercising and staying active (though a person should avoid weightlifting)
- avoiding hot tubs and high altitudes
- eating a balanced diet low in saturated fat
- seeking medical advice before trying to become pregnant, if applicable
Pulmonary hypertension typically worsens over time. If a person does not receive treatment, it can be fatal.
The quicker a person notices symptoms and seeks treatment, the more effective treatment will be in helping to prevent symptom progression.
The following charities and organizations provide help, advice, and information to those affected by pulmonary hypertension:
This section answers some frequently asked questions about pulmonary hypertension treatments.
What is the best treatment for pulmonary hypertension?
The best treatment for pulmonary hypertension depends on the underlying cause.
- A person with CTEPH may benefit from anticoagulants and a pulmonary endarterectomy.
- A person with pulmonary hypertension due to left heart disease or lung disease
may benefit from diuretics. - A doctor may prescribe oxygen therapy to treat PAH.
What is the latest treatment for pulmonary hypertension?
Recent advances in
Stem cells have not yet differentiated into specific roles. This means they can develop into any type of cell, depending on the conditions. They can then multiply to create more of the same cell.
This makes stem cells useful in repairing and regenerating lost and damaged tissue.
Preclinical animal studies have shown that stem cell therapy could potentially help to treat pulmonary hypertension and PAH. However, experts still need to do more research.
Can pulmonary hypertension go away?
No, there is often no cure for pulmonary hypertension. However, there are effective treatments that can significantly reduce symptoms and make the condition more manageable.
A 2015 review suggests that a pulmonary endarterectomy — a surgical procedure that removes blood clots — may have the potential to cure CTEPH. However, eligibility for this procedure may depend on factors such as the individual’s overall health.
A doctor may use different methods to treat pulmonary hypertension, depending on the cause. Treating the underlying cause is the best way to reduce symptoms.
Medications to treat pulmonary hypertension include anticoagulants and diuretics.
A doctor may also recommend surgical treatments, such as a balloon pulmonary angioplasty or lung transplant. However, a doctor may only recommend these treatments if medication does not produce the desired effects. It is also important to note that not everyone is eligible for surgical treatments.
Treatment is not typically curative. However, it can help reduce a person’s symptoms and make pulmonary hypertension easier to manage.