Introduction:

Pulmonary hypertension is high blood pressure in the arteries of your lungs. It happens when the lung's tiny arteries narrow or become blocked. To keep blood flowing through these narrowed blood vessels, pressure increases in the arteries, which makes the lower right chamber (right ventricle) of your heart work harder. Eventually your heart begins to weaken and fail. Pulmonary hypertension can occur by itself, but it is often caused by an existing disease. It is a rare condition that mostly affects women in their 30s or 40s. Treatments can reduce symptoms and improve quality of life.

Signs and Symptoms:

The most common symptom is shortness of breath, first when you exercise and later while at rest. Other symptoms are:

• Getting tired easily
• Fainting or dizziness
• Cough
• Chest pain
• Swelling in your legs
• Blue lips or skin

What Causes It?:

Sometimes there is no known cause. When that is the case, the condition is called idiopathic pulmonary hypertension. If another medical condition is causing the problem, it is called secondary pulmonary hypertension. Conditions that can lead to pulmonary hypertension include the following:

• Heart disease
• Mitral stenosis or regurgitation
• Certain kinds of lung disease
• Obesity, especially with sleep apnea
• Chronic obstructive pulmonary disease (COPD)
• High altitude
• Left-side heart failure
• Sickle cell anemia

What to Expect at Your Provider's Office:

Your health care provider will give you a thorough examination and order laboratory tests to diagnose your condition. You may have an x-ray or electrocardiogram (ECG). Other tests may include an echocardiogram, heart catheterization, lung scan, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) scan.

Treatment Options:

If your pulmonary hypertension is the result of another condition, that disease must be treated. You must avoid too much physical stress or exercise, although mild regular exercise may help reduce symptoms like shortness of breath. Ask your doctor to create an exercise plan for you. If your disease has progressed, your doctor may recommend you have a lung or heart lung transplantation.

Drug Therapies

Some treatments your health care provider may use include the following:

• Supplemental oxygen
• Vasodilators -- open narrowed arteries. Epoprostenol (Flolan) is given intravenously (IV) through a small catheter attached to a portable pump. Iloprost (Ventavis) is a version of the same drug that you inhale.
• Endothelin receptor antagonists -- help open blood vessels by blocking endothelin, a substance that causes blood vessels to constrict. These drugs include bosentan (Tracleer) and ambrisentan (Letairis).
• Anticoagulants -- such as warfarin (Coumadin) to keep blood clots from forming.
• Diuretics (water pills) -- to get rid of excess fluid in your body that can build up in your lungs and make your heart work harder

Complementary and Alternative Therapies

If you have pulmonary hypertension, you should be under a doctor' s care. Complementary and alternative therapies can be used with medical treatment, but only with your doctor's supervision. Do not use complementary and alternative therapies by themselves to treat pulmonary hypertension.

Nutrition

While none of these supplements specifically treats pulmonary hypertension, they can help heart health and function:

• Coenzyme Q10 (200 - 600 mg per day) is good for heart health, is an antioxidant, and may help lower blood pressure. Do not take coenzyme Q10 if you take blood-thinning medication (anticoagulants).
• L-carnitine (500 mg three times per day) improves endurance and is good for heart health. Do not take L-carnitine if you take blood-thinning medication (anticoagulants) or thyroid hormone.
• Magnesium (200 mg two to three times per day) helps your heart work efficiently and may help lower blood pressure. Magnesium interacts with many medications as well as other herbs and supplements, so talk to your doctor before taking magnesium.
• Potassium (20 mg per day) improves the ability of the heart muscle to contract. If you take a certain kind of diuretic, your doctor may recommend you also take a potassium supplement. The dose will depend on the level of potassium in your blood, so your doctor will determine the proper amount. However, with other kinds of diuretics taking a potassium supplement might cause you to get too much potassium. Ask your doctor before taking extra potassium.
• Vitamin E (400 IU per day) and vitamin C (250 - 500 mg two times per day) are antioxidants that protect the heart and strengthen the immune system.
• Taurine (1,000 mg twice a day) is good for heart health and may help lower blood pressure.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Do not take these herbs without your doctor' s supervision. Many interact with each other and with other prescription medications, and can cause side effects. These herbs have not been studied specifically for pulmonary hypertension.

• Hawthorn (Crataegus monogyna), 240 - 600 mg per day. Hawthorn has been shown to help reduce symptoms of heart failure, and some people think it may help lower blood pressure, although so far studies are lacking.
• Linden (Tilia cordata), 1 - 2 cups tea per day. May help the body get rid of excess fluid. To make tea, steep 2 g in one cup boiling water. Strain and cool. Do not take linden if you take diuretics (water pills).
• Garlic (Allium sativum), 600 - 900 mg per day. May help lower blood pressure. Garlic may increase the risk of bleeding, especially if you take blood-thinning medications (anticoagulants) like warfarin (Coumadin). Ask your doctor before taking garlic.
• Rosemary (Rosmarinus officinalis), 1 cup tea three times per day. May help the body get rid of excess fluid. To make tea, steep 1 - 2 g of rosemary leaves in one cup boiling water. Strain and cool. Do not take rosemary if you take diuretics (water pills).
• Danshen (Salvia miltiorrhiza) dilates blood vessels. Dosage varies and should be determined by your doctor. Do not take danshen if you take blood thinners (anticoagulants).

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Castor oil pack. Apply oil to a clean, soft cloth, place on chest and cover with plastic wrap. Place a heat source over the pack and let sit for 30 - 60 minutes. Use for 3 consecutive days, take 1 - 2 days off, and then repeat 3-day cycle.

Contrast hydrotherapy. Alternate hot and cold applications to the chest. Alternate 3 minutes hot with 1 minute cold. Repeat three times to complete one set. Do two to three sets per day.

Steams. Using three to six drops of essential oils in a humidifier, vaporizer, atomizer, or warm bath may help reduce shortness of breath and improve circulation. Consider eucalyptus, rosemary, thyme, or lavender.

Acupuncture

May help improve circulation.

Following Up:

Pulmonary hypertension is a progressive disease, meaning it gets worse over time. It' s important to work closely with your doctor to treat your symptoms and adjust your medication as needed.

Special Considerations:

For the most part, women who have primary pulmonary hypertension should not get pregnant because the condition is dangerous for both mother and baby.