Donot Ignore Pulmonary Hypertension Any Longer. It's Time to Deal with it!

ulmonary hypertension (PH) is a condition that not only causes many problems for those suffering from it, but also can exacerbate and complicate many other diseases. PH can be responsible for mortality in many patients. Tackling PH is not exclusively related to the field of cardiovascular diseases. Many other diseases in other fields of medicine may interfere with PH. Pulmonary diseases, renal, hepatic, collagen vascular disease, infectious and hematologic disease may be related with PH. In patients suffering from aforementioned diseases, PH can exacerbate the primary disorder and even cause mortality. Pregnant women afflicted with PH have a 30-50% mortality rate.1 Newborns and children with pulmonary or cardiovascular disorders can be later afflicted by PH. PH drastically increases the risk in surgeries and in anesthesia and can be the cause of mortalities2 or deteriorated outcomes in patients after surgery.3 According to the latest guidelines,4 there are 5 categories of PH (Table 1): 1Pulmonary arterial hypertension 2Pulmonary venous hypertension (previously named pulmonary hypertension due to left heart disease) 3Pulmonary hypertension associated with hypoxemic lung disease 4Pulmonary hypertension caused by chronic thromboembolic disease 5Pulmonary hypertension from conditions with uncertain mechanisms For a long time, the science of medicine had no remedy for PH and physicians could only stand by and watch PH patients die. After some time, factors which complicate PH are known and it has been shown that controlling these factors is helpful. Patients are advised, for instance, to refrain from heavy exertion, to avoid pregnancy, and to be vaccinated against the flu and pneumococcal infections. PH patients’ life expectancy has increased dramatically as a result of this newly acquired knowledge. Table 1. Classification of pulmonary hypertension Category 1: Pulmonary Arterial Hypertension Idiopathic (IPAH) Sporadic Familial From exposure to drugs or toxins From exposure to HIV infection Persistent pulmonary hypertension of the newborn Associated with other active conditions: Congenital systemic to pulmonary shunts Collagen vascular disease Portal hypertension Pulmonary capillary hemangiomatosis (PCH)