Treatment of Pulmonary Hypertension
In most patients, pulmonary hypertension has an identifiable cause. For these people, finding and treating the underlying cause is the best option.
For certain people, advanced treatments to directly lower the blood pressure in the pulmonary arteries can help. These medicines may sometimes prevent progression of pulmonary hypertension:
- Prostanoids, including epoprostenol, treprostinil, or iloprost
- Endothelin receptor antagonists, such as bosentan and ambrisentan
- Phosphodiesterase inhibitors, like sildenafil
- Soluble guanylate cyclase stimulators, like riociguat
In people with severe advanced pulmonary hypertension, for whom drug therapy hasn't worked, other treatment options are available:
- Lung transplantation: An organ donor's lungs and pulmonary arteries are transplanted into someone with severe pulmonary hypertension.
- Atrial septostomy: A surgeon creates an opening between chambers on the right and left sides of the heart. Atrial septostomy improves pulmonary hypertension, but often causes serious side effects.
Other treatments can reduce the symptoms of pulmonary hypertension in some people:
Exercise may be the best treatment for pulmonary hypertension. Regular exercise reduces shortness of breath and allows people with pulmonary hypertension to be more active.
Inhaled oxygen can improve shortness of breath in some people. Oxygen can also help people live longer with pulmonary hypertension that's caused by chronic lung disease.
Blood thinners (anticoagulants) could help people with chronic blood clots in the lungs causing pulmonary hypertension.
Calcium channel blockers (nifedipine, diltiazem, or amlodipine) may improve symptoms in a minority of people with pulmonary hypertension, if they respond to a vasodilator at right heart catheterization.
What to Expect With Pulmonary Hypertension
The prognosis of pulmonary hypertension varies according to what's causing it. Some conditions that cause pulmonary hypertension may improve with time and treatment.
Idiopathic pulmonary arterial hypertension (primary pulmonary hypertension) is a progressive condition. Symptoms of this form of pulmonary hypertension steadily worsen with time.
Although there's not a cure, treatments can extend life and reduce the symptoms of primary pulmonary hypertension.