What is Pulmonary Arterial Hypertension

Pulmonary arterial hypertension referred to a high level of blood pressure in the pulmonary arteries. Pulmonary arteries are the large blood vessels of the body and these vessels are responsible for the transport of blood from the right ventricle of the heart toward the lungs.
PAH is not like other types of blood pressure it is a different type of blood pressure. other kinds of blood pressure are systematic blood pressure and some kinds of pulmonary hypertension. All kinds of blood pressure are related to each other through different links but pulmonary arterial hypertension is different and most of the time doctors are unable to understand its cause.
In this article, we will discuss the symptoms, causes, and treatment of
pulmonary arterial hypertension and the difference between Pulmonary hypertension and other forms of hypertension.

Pulmonary Arterial Hypertension

According to the National Organization for Rare Disorders (NORD), P AH can be defined as high blood pressure which lies in the arteries of the lungs, and the reason for this kind of hypertension is still not known. In the body of a PAH patient, the rate of blood flow from the heart into the lungs is much higher than normal.
According to the American Heart Association (AHA), the normal pulmonary blood pressure ranges from 8 to 20 millimetres of mercury (mmHg). The PAH can be diagnosed when the resting pulmonary blood pressure reaches higher than 25 mm Hg.

What is the difference between pulmonary arterial hypertension and pulmonary hypertension?
According to AHA pulmonary arterial hypertension and pulmonary hypertension are not different because in both cases the rate of blood flow increases significantly as a result of high blood pressure developing in the pulmonary artery.
The only point which makes PAH distinct from some other forms of pulmonary hypertension is that PAH destroys the wall of the artery inside the lungs.

The difference between pulmonary arterial hypertension and systematic blood pressure?
Systematic blood pressure is simply a pressure that measures the force through which blood flows to the arteries throughout the body.
According to the Center for Disease Control and Prevention (CDC), the pressure below 120 to 80 mmHg is normal systematic pressure.
If the blood pressure of an individual is 130 to 80 mmHg, then it is found that the individual is suffering from hypertension. When the blood pressure of a person remains between 140 to 90 mmHg then doctors recommend the treatment because it is an alarming situation.
PAH is not as common as compared to systematic hypertension. But they both are responsible for heart problems. PAH can lead to heart failure.

Causes

Most of the time the causes of PAH are not clear. NORD research found that the PAH is much more common in females as compared to males and the chances of development of PAH are higher in 30 to 60 years old individuals
The researcher has found that the sex hormones of females are responsible for the development of PAH and that the chances of PAH formation are much higher during or after the pregnancy period.
PAH is also linked with genetics. About 15 to 20 per cent of cases are related to the genetic history of the individual. It means that if your family members such as your mother or father have this problem then it will increase the chances that you may get this in your life.
Modification of a gene which is called BMPR2 may result in the development of PAH, but this is not true in all cases.
Almost in 80 per cent of individuals, BMPR2 is not the cause of PAH. It means that some lifestyle factors have contributed to triggering the condition.
Researchers suggest that PAH is linked to several drugs. Which includes
• Dasatinib (Sprycel), is a leukaemia medication
• Methamphetamines
• Dexfenfluramine and fenfluramine these drugs are called t drugs and they are available in the two brands named Pondimin and Redux
Some health conditions can also lead to PAH and these are
• Congenital Heart Disease
• Liver Disease
• Connect tissue disorder
• Sickle cell disorder

Symptoms

One of the common symptoms of pulmonary arterial hypertension is the presence of a low level of oxygen in the blood. In this condition, the individual goes through problems with breathing after exertion
Other symptoms include
• Weakness
• Fatigue
• Dizziness
• Chest pain
• Cough
• Swelling of ankles, face, feet, and stomach
Those individuals in which PAH takes its advanced form can also experience cyanosis, in this condition the skin, lips, and tongue undergo discolouration.
The effect of cyanosis is different as it is based on the skin colour of the individual. In those people that have the white colour of skin, the cyanosis changes the skin and lip colour to blue. In black individuals, the skin and lips colour may change into grey.
Most of the symptoms of PAH are similar to heart conditions which indicates that it is not easy to diagnose PAH with the help of symptoms.

Diagnosis

Right heart catheterization is one of the easiest methods to detect PAH. In this method, the rate of blood flow is measured.
In this technique, the doctor uses a thin tube which is known as a catheter, and moves it into the neck or vein and also in the pulmonary artery through another vessel. This will enable the doctor to understand the rate of blood flow in the body. A person does not sleep during the condition but the doctor gives the patient some medicines so that he feels relaxed during the procedure.
Some other tests taken by the doctors are
• Lung function and breathing test
• An echocardiogram
• An electrocardiogram
• Blood tests
• Functional assessment

Treatment

According to the Food and Drug Administration (FDA), the following drugs are effective in PAH treatment.
• Vasodilators
These drugs are effective for those blood vessels that become narrow and they help widen them. It can lower blood pressure.
• Prostaglandins
These drugs are effective for those individuals who do not take any other therapy.
• Phosphodiesterase type 5 inhibitors
These drugs help control the high blood pressure in the arteries during any physical activity such as exercise or walking.
• Endothelin receptor antagonists
These drugs help improve the low amount of oxygen in the blood and help the individual in breathing.

Lifestyle changing

Lifestyle plays a major role in the development of PAH. A person can change his lifestyle if he wants to get rid of PAH and many times doctor also recommends some changes in the lifestyle as it is effective for the control of PAH.
• Quitting smoking
• Following the DASH diet
• Regular exercise
• Avoid Alcohol
• Moderate weight

Conclusion

Pulmonary arterial hypertension occurs in the pulmonary arteries and these blood vessels take blood to the lungs Furthermore, there is no treatment available for the disease. However, doctors can help you to control it and can save your life. PAH becomes more severe as time passes and it can lead to a life life-threatening situation.
In the last 20 years, the survival rate of patients has improved significantly.
At the initial stage, PAH does not show any clear symptoms and the patient remains unaware of its development. So, one should remain conscious of the health conditions, and whenever you feel disturbed or uncomfortable visit your doctor.
Always contact your doctors before taking any medicine. They will help you in the right way.

Self-monitoring is the most important key to understanding the effectiveness of your healthcare regime. It is important to use clinically-validated solutions to self-monitor your progress.

ForaCare’s hypertension solutions for self-monitoring offer professional clinically-validated accuracy for ease of mind when testing.

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References
– https://www.medicalnewstoday.com/articles/pulmonary-arterial-hypertension
– Benza, R. L ., et al. (2012). An evaluation of long-term survival from time of diagnosis in pulmonary arterial hypertension from the REVEAL Registry.
https://journal.chestnet.org/article/S0012-3692(12)60459-0/fulltext
– Chapter 11: Pulmonary hypertension. Cardiovascular Disability: Updating the Social Security Listings. (2010).
https://www.ncbi.nlm.nih.gov/books/NBK209987/
– Color awareness: A must for patient assessment. (2011).

Color awareness: A must for patient assessment


– Facts about hypertension. (2020).
https://www.cdc.gov/bloodpressure/facts.htm
– Lai, Y.-C., et al. (2015). Pulmonary arterial hypertension: The clinical syndrome.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4096686/
– Pulmonary arterial hypertension. (2021).

Pulmonary Arterial Hypertension


– Pulmonary arterial hypertension symptoms and diagnosis. (2020).
https://www.lung.org/lung-health-diseases/lung-disease-lookup/pulmonary-arterial-hypertension/symptoms-diagnosis
– Pulmonary hypertension — high blood pressure in the heart-to-lung system. (2016).
https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/pulmonary-hypertension-high-blood-pressure-in-the-heart-to-lung-system
– What is pulmonary hypertension? (2021).
https://www.thoracic.org/patients/patient-resources/resources/pulmonary-hypertension.pdf