Understanding Pulmonary Hypertension Causes, Symptoms, Treatments in 2026

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

What Is Pulmonary Hypertension and How Does It Affect Heart and Lung Function?

Pulmonary hypertension (PH) refers to a type of high blood pressure that affects the arteries in the lungs and the right side of the heart. Unlike systemic hypertension, which affects the entire body, PH specifically impacts the pulmonary circulation. The condition causes the walls of the pulmonary arteries to thicken and narrow, increasing resistance to blood flow from the heart to the lungs. This increased resistance forces the right ventricle of the heart to pump harder to push blood through, leading to muscle strain and enlargement of the ventricle. Over time, this sustained effort can weaken the right ventricle, potentially leading to heart failure.

Primary Causes and Risk Factors of Pulmonary Hypertension in the United States

Pulmonary hypertension is categorized into five groups based on its underlying causes. Group 1, known as pulmonary arterial hypertension (PAH), is often idiopathic (without known cause) but can also be hereditary or associated with certain conditions like connective tissue diseases (e.g., scleroderma, lupus), congenital heart disease, or HIV infection. Group 2 PH results from left-sided heart disease, which is a common cause in the United States. Group 3 PH is related to lung diseases and hypoxia, such as chronic obstructive pulmonary disease (COPD) or sleep apnea. Group 4 PH stems from chronic blood clots in the lungs (chronic thromboembolic pulmonary hypertension, CTEPH). Group 5 PH is caused by various other conditions, including blood disorders, metabolic disorders, or tumors. Risk factors can include a family history of PH, obesity, exposure to certain drugs or toxins, and existing heart or lung conditions.

Recognizing the Symptoms of Pulmonary Hypertension

The symptoms of pulmonary hypertension often develop gradually and can be mistaken for other conditions, making early diagnosis challenging. Common symptoms include shortness of breath, especially during exertion, which may progress to occurring even at rest. Fatigue and weakness are also prevalent, as the heart struggles to adequately oxygenate the body. Other signs can include chest pain or pressure, dizziness or fainting spells (syncope), swelling in the ankles, legs, or abdomen (edema) due to fluid retention, and a bluish tint to the lips or skin (cyanosis) in more advanced stages. Patients may also experience a racing heartbeat or palpitations. It is crucial for individuals experiencing these symptoms to seek medical attention for proper evaluation.

How Pulmonary Hypertension Is Diagnosed in US Clinical Settings

Diagnosing pulmonary hypertension typically involves a comprehensive approach in US clinical settings. Initial assessments often include a physical exam, review of medical history, and basic tests such as an electrocardiogram (ECG) and chest X-ray. An echocardiogram, a non-invasive ultrasound of the heart, is a key screening tool as it can estimate the pressure in the pulmonary arteries and assess right heart function. If PH is suspected, a right heart catheterization is considered the gold standard for definitive diagnosis. This invasive procedure directly measures the pressures in the heart and pulmonary arteries. Further tests, like lung function tests, CT scans of the chest, ventilation-perfusion scans, and blood tests, are often performed to identify the underlying cause and determine the specific group of PH.

Overview of Medical Treatments for Pulmonary Hypertension

Treatment for pulmonary hypertension aims to manage symptoms, improve quality of life, and slow the progression of the disease. The specific treatment plan depends on the type and severity of PH. For Group 1 PAH, medications may include vasodilators, which relax and widen narrowed blood vessels, such as prostacyclin analogues, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors. Diuretics might be prescribed to reduce fluid retention, while anticoagulants help prevent blood clots. Oxygen therapy can be beneficial for those with low oxygen levels. For other groups of PH, treatment focuses on addressing the underlying condition; for instance, managing left-sided heart disease, treating lung diseases, or performing surgery for chronic blood clots (pulmonary endarterectomy for CTEPH). In some severe cases, lung transplantation may be considered.

Pulmonary hypertension is a complex and progressive condition that requires ongoing medical management. Advances in diagnostic tools and treatment options continue to offer hope for individuals affected by this disease. Early detection and a personalized treatment plan, often involving a multidisciplinary team of specialists including cardiologists and pulmonologists, are essential for optimizing patient outcomes and improving the long-term outlook for those living with PH.