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Pulmonary Hypertension (PH)

Pulmonary hypertension, or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen.

PubMed Health Glossary
(Source: NIH - National Heart, Lung, and Blood Institute)

Pulmonary Hypertension (PH)

Pulmonary hypertension (PULL-mun-ary HI-per-TEN-shun), or PH, is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen.

PH causes symptoms such as shortness of breath during routine activity (for example, climbing two flights of stairs), tiredness, chest pain, and a racing heartbeat. As the condition worsens, its symptoms may limit all physical activity.

Overview

To understand PH, it helps to understand how your heart and lungs work. Your heart has two sides, separated by an inner wall called the septum.

Each side of your heart has an upper and lower chamber. The lower right chamber of your heart, the right ventricle (VEN-trih-kul), pumps blood to your pulmonary arteries. The blood then travels to your lungs, where it picks up oxygen.

The upper left chamber of your heart, the left atrium (AY-tree-um), receives the oxygen-rich... Read more about Pulmonary Hypertension

What works? Research summarized

Evidence reviews

Milrinone for persistent pulmonary hypertension of the newborn

Persistent pulmonary hypertension of the newborn (PPHN) is a condition caused by a failure in the systemic and pulmonary circulation to convert from the antenatal circulation pattern to the normal postnatal pattern. Due to persistent high pressure in the pulmonary vessels, less than normal blood flows to the lungs and thus less oxygen reaches the organs of the body. Milrinone may cause the pulmonary vessels to relax and allow for an increased oxygen supply for the body. However, the review found no trials of the use of milrinone for babies with persistent pulmonary hypertension. Research is needed into the effects of milrinone on PPHN.

Hydralazine for pulmonary hypertension in low birth weight infants with chronic lung disease

In premature infants, pulmonary arterial hypertension (PAH) associated with chronic lung disease (CLD) is associated with high mortality rate. With the exception of oxygen supplementation, no specific interventions have been established as an effective treatment for PAH in premature infants with CLD. Vasodilators could be effective treatments to reduce pulmonary arterial pressure, but little has been proven regarding their clinical effectiveness and concern remains regarding adverse effects. This review found no trials of the use of hydralazine for low birth weight infant with PAH related to CLD. However, since hydralazine is inexpensive and potentially beneficial, randomised controlled trials are recommended.

Phosphodiesterase 5 (sildenafil) inhibitors for pulmonary hypertension

Pulmonary hypertension (PH) is high blood pressure in the lung circulation. It can occur without a known cause, or it can be caused by another lung disease or be secondary to abnormalities in the left side of the heart. The review sought to determine whether there was evidence that sildenafil (also known as Viagra), a drug which opens up the arteries and increases the flow of blood, could decrease pulmonary artery blood pressure and alleviate symptoms of PH. A limited number of studies of short term i duration indicated that the drug can open up the arteries. One small longer‐term study found some favourable effects in terms of symptoms, but in the absence of longer term outcomes, we could not establish whether this meant that the people given the drug felt that their levels of daily activity were better. Future studies should be longer in duration, and should measure the impact of treatment on daily activities, mortality, quality of life and exercise capacity.

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Summaries for consumers

Milrinone for persistent pulmonary hypertension of the newborn

Persistent pulmonary hypertension of the newborn (PPHN) is a condition caused by a failure in the systemic and pulmonary circulation to convert from the antenatal circulation pattern to the normal postnatal pattern. Due to persistent high pressure in the pulmonary vessels, less than normal blood flows to the lungs and thus less oxygen reaches the organs of the body. Milrinone may cause the pulmonary vessels to relax and allow for an increased oxygen supply for the body. However, the review found no trials of the use of milrinone for babies with persistent pulmonary hypertension. Research is needed into the effects of milrinone on PPHN.

Hydralazine for pulmonary hypertension in low birth weight infants with chronic lung disease

In premature infants, pulmonary arterial hypertension (PAH) associated with chronic lung disease (CLD) is associated with high mortality rate. With the exception of oxygen supplementation, no specific interventions have been established as an effective treatment for PAH in premature infants with CLD. Vasodilators could be effective treatments to reduce pulmonary arterial pressure, but little has been proven regarding their clinical effectiveness and concern remains regarding adverse effects. This review found no trials of the use of hydralazine for low birth weight infant with PAH related to CLD. However, since hydralazine is inexpensive and potentially beneficial, randomised controlled trials are recommended.

Phosphodiesterase 5 (sildenafil) inhibitors for pulmonary hypertension

Pulmonary hypertension (PH) is high blood pressure in the lung circulation. It can occur without a known cause, or it can be caused by another lung disease or be secondary to abnormalities in the left side of the heart. The review sought to determine whether there was evidence that sildenafil (also known as Viagra), a drug which opens up the arteries and increases the flow of blood, could decrease pulmonary artery blood pressure and alleviate symptoms of PH. A limited number of studies of short term i duration indicated that the drug can open up the arteries. One small longer‐term study found some favourable effects in terms of symptoms, but in the absence of longer term outcomes, we could not establish whether this meant that the people given the drug felt that their levels of daily activity were better. Future studies should be longer in duration, and should measure the impact of treatment on daily activities, mortality, quality of life and exercise capacity.

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Terms to know

Aorta
The largest artery in the body. It carries oxygen-rich blood away from the heart to vessels that reach the rest of the body.
Arteries
A blood vessel that carries blood from the heart to tissues and organs in the body.
Atria
The chambers of the heart, to which the blood returns from the circulation.
Heart
The hollow, muscular organ that maintains the circulation of the blood.
Heart Ventricles
The lower right and left chambers of the heart.
Interventricular Septum
Interventricular septum is the stout wall separating the lower chambers (the ventricles) of the heart from one another.
Lungs
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
Oxygen
A colorless, odorless gas. It is needed for animal and plant life. Oxygen that is breathed in enters the blood from the lungs and travels to the tissues.
Pulmonary
Having to do with the lungs.
Pulmonary Artery
The pulmonary artery and its branches deliver blood rich in carbon dioxide (and lacking in oxygen) to the capillaries that surround the air sacs.
Pulmonary Circulation
The circulation of the blood through the lungs.

More about Pulmonary Hypertension

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Also called: PHT

Other terms to know: See all 11
Aorta, Arteries, Atria

Related articles:
How the Heart Works
How the Lungs Work

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