Pulmonary Arterial Hypertension
Pulmonary arterial hypertension (PAH) is one form of pulmonary hypertension (high blood pressure in the lungs).
In PAH, the pulmonary arteries become stiff and dysfunctional. They can thicken or narrow as the disease progresses.
[A] The heart has to work harder to push blood through the stiff, narrow arteries. This causes the blood pressure in the lungs to rise.
The major types of PAH include:
- Idiopathic — developing without an apparent or known cause
- Heritable — common among family members due to a genetic mutation
- Drug and toxin-induced PAH
PAH can also be associated with other conditions, such as:
Idiopathic Pulmonary Arterial Hypertension (IPAH)
- IPAH is a rare disease affecting less than 200,000 people in the United States.
- Women are twice as likely to generate the disease as compared to men.
- This is the most common disorder among the group of diseases within this category in the U.S.
IPAH symptoms, diagnosis, and treatments
Because symptoms of IPAH can be similar to more common diseases — such as asthma, COPD, or obesity — diagnosis is often delayed.
So, it is important for doctors to have a suspicion of PAH when they consider possible causes for shortness of breath.
Doctors at the UPMC Comprehensive Pulmonary Hypertension Program perform the following screenings and tests to diagnose IPAH:
- Right heart catheterization
Medical treatments for IPAH can include:
- Oral medications
- Inhaled medications
- Subcutaneous and intravenous medications
Doctors choose the medication based on the severity of disease. Often, they will start patients on oral medication, and — if the disease worsens — prescribe additional medicines.
Close follow up with a PH specialist is essential to monitor progress of treatment.
In addition to medicine, doctors may:
- Prescribe a low-salt diet to minimize fluid retention.
- Advise monitored pulmonary rehabilitation.
- Refer patients for a lung transplant evaluation in the event their disease is severe or progresses despite medicines.
Heritable Pulmonary Arterial Hypertension (HPAH)
- In few cases, PAH can run in families. HPAH is due to a genetic mutation passed from generation to generation.
- Approximately 20 percent of people with this gene mutation develop HPAH.
- Inheriting a genetic mutation from one’s parent does not mean that a person will automatically get PAH, however it does mean that the risk is higher than in the general population.
Drug and Toxin-Induced Pulmonary Arterial Hypertension
- PAH came to the forefront as an epidemic when a particular diet drug came on the market.
- The drug was removed from the market, but other drugs have been associated with PAH since then.
Definite risk factors for drug and toxin-induced PAH
- Appetite suppressants
- Toxic rapeseed oil
- Chemotherapeutic agents
Likely risk factors
- Selective serotonin reuptake inhibitors taken during pregnancy have been associated with persistent PAH of the newborn.
Possible risk factors
- Chemotherapeutic agent
Unlikely risk factors
- Oral contraceptives
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Learn More About Pulmonary Arterial Hypertension and Other Breathing Disorders