Pulmonary Hypertension Treatment Options

In this video, a Temple nurse practitioner talks about several treatment options for pulmonary hypertension.

There is no cure for pulmonary hypertension. Treatment is usually aimed at slowing or stopping the progression of the disease, and treating the symptoms.

Treatment may vary depending on the type of pulmonary hypertension you have and how serious it is. Treatments tend to be complicated and require lots of follow-up care.

The following treatments may be used alone or in combination in treating pulmonary hypertension:

Lifestyle

If you smoke, it's important to quit smoking. Your doctor can help you by recommending programs and products that can help you quit. You should also avoid secondhand smoke, and places where other lung irritants — such as dust, fumes or toxic substances — are present as much as possible.

Physical activity can help to improve your overall wellness. Your doctor can help you determine what kinds of activity are safe for you.
Avoid becoming pregnant, as pregnancy with pulmonary hypertension can be life-threatening for the mother and baby.
Avoid high altitudes because it can cause your blood to become slightly thicker, which can make pulmonary hypertension and its effects worse.
Eat a nutritious diet that is low in salt, including whole grains, vegetables, lean meats and low-fat dairy products. Maintain a healthy weight. Focus on finding ways to reduce stress and maintain a strong support system in your life, including reaching out to family and friends for support, or joining a support group.

Medications

There are several medication types that are used to treat pulmonary hypertension:

Prostanoids — medications that work to open the arteries in the lungs by targeting a specific mechanism in the body called the prostacyclin pathway. Prostanoid medications increase the amount of prostacyclin in the body, which in turn helps to relax and open the pulmonary arteries. Until recently, prostanoids were available only as an infusion, administered intravenously, or in an inhaler. Oral forms of prostanoid medications are currently available.
Endothelin receptor antagonists — reverse the effects of endothelin, which is a substance inside the walls of blood vessels that causes narrowing. There are several endothelin receptor antagonists available.
Phosphodiesterase Type 5 (PDE5) inhibitors — work by blocking the action of PDE5, a substance in the smooth muscle lining the arteries in the lungs that causes them to constrict. This causes these blood vessels to open, allowing blood to flow more easily.
Soluble guanylate cyclase stimulator — soluble guanylate cyclase (sGC) is a chemical in the body that interacts with nitric oxide. There is a medication available that stimulates sGC to carry out interactions with nitric oxide, which in turn helps more blood flow through the blood vessels in the lung.
Anticoagulants — help prevent blood clots from forming by interfering with the body’s blood coagulation mechanism. They can increase the risk of bleeding and can interact with many other drugs, herbal supplements and foods.
Diuretics — eliminate excess water or fluid from the body. This helps treat pulmonary hypertension by reducing the amount of work for your heart.

Oxygen Therapy

Oxygen therapy — oxygen is administered using a mask or a pronged tube that is placed just under the nose. The prongs then deliver oxygen directly into the nose. Oxygen therapy may be administered only during sleep or during exercise, but can be administered all the time in some patients.

Surgery

Surgery is usually a last resort for people who have more severe pulmonary hypertension that's not improved with medication or other treatments. Temple pulmonologists and cardiologists specialize in advanced pulmonary hypertension treatment, such as:

Lung transplant — an option for some patients with pulmonary hypertension. Most often, transplant surgery is considered for younger patients with pulmonary hypertension that does not have a known cause.
Pulmonary thromboendarterectomy (PTE) — a type of surgery that involves removing blood clots from the pulmonary arteries, restoring blood flow.