(This is a sample entry from our Q&A Treasure chest, a database with hundreds of entries to support students with their patient and client work. Unlimited access is included as part of our Core 101 Semester program.)
A potential client of mine was just diagnosed with pulmonary hypertension and given a depressing prognosis. Are you familiar with this?? I would appreciate some guidance on where to begin in terms of focus. Thanks so much!
I am! Pulmonary hypertension is different than traditional high blood pressure in that pulmonary hypertension (PHTN) is high blood pressure that occurs specifically in the arteries of the lungs. It is a different measurement altogether from systemic blood pressure and reflects the pressure the heart must exert to pump blood from the heart through the arteries of the lungs specifically.
The human body has two separate arms of the circulatory systems. Typically “blood pressure” and a diagnosis of “high blood pressure” or “hypertension” refer to the systemic blood pressure throughout your body. This is typically measured in the brachial artery of your arm. Pulmonary blood pressure refers to the blood flow in your lungs, essentially a separate “loop” in the circulatory system. The right side of the heart receives the oxygen-emptied blood as it returns from the body and pumps this blood into the blood vessels of the lungs, where the blood gathers oxygen again. From there, blood leaves the lungs and enters the left side of the heart to carry the oxygen-rich blood to the body again. This is an excellent overview clinical paper.
You may learn more about typical symptoms of PHTN here.
Because blood vessel dysfunction in the lungs can have a dramatic effect on the entire body, conventional treatment often involves common hypertension drugs as well as blood thinners (e.g. warfarin). Supplemental Oxygen is recommended to maintain oxygen saturation greater than 90% in those patients who are more compromised. There are more advanced drugs used for those who have acute reduction in oxygen availability.
Lifestyle modifications that avoid putting too much pressure on the lungs are usually recommended. For example, avoiding lifting objects that weight more than 15-20 lbs. and avoiding all strenuous exercise and avoiding travel to higher altitude destinations (where there is less oxygen in the air). Regular mild or gently moderate exercise (e.g. walking), however, is critical for retaining lung function. Activities such as yoga and tai chi can help to build and retain muscle mass without an intense cardio effect.
Persistently higher pressure of the blood coming from the lungs into the heart puts pressure on the heart to work harder. This can cause hypertrophy of the heart, and over time without abatement, PHTN can lead to heart failure simply due to lack of oxygenation. However, as with so many other diagnoses in the body, it is just as key in PHTN as in regular hypertension to get to the true root causes of dysfunction in the blood vessels. These are common factors to consider:
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