While most people are familiar with regular hypertension, pulmonary hypertension is a lesser-known but serious condition that affects the lungs and heart. Although both conditions involve high blood pressure, they impact different parts of the cardiovascular system, requiring distinct treatment approaches. Here’s a breakdown of how pulmonary hypertension differs from regular hypertension.

What is Pulmonary Hypertension?

Pulmonary hypertension (PH) is characterized by elevated blood pressure in the pulmonary arteries, which are the vessels that carry blood from the heart to the lungs. Unlike regular blood pressure, which involves systemic arteries throughout the body, pulmonary hypertension specifically affects the lungs. The increased pressure in the pulmonary arteries forces the right side of the heart to work harder to pump blood, and over time, this strain can lead to heart failure.

There are five main types of pulmonary hypertension, categorized based on their causes:

• Group 1 (Pulmonary Arterial Hypertension – PAH): This involves narrowing or blockages in the pulmonary arteries, which can be caused by factors like genetics, certain medications, or heart defects.
• Group 2: Caused by left-sided heart disease, where pressure in the lungs increases due to heart issues like mitral valve disease.
• Group 3: Linked to chronic lung conditions, such as COPD or pulmonary fibrosis, which cause changes in the pulmonary arteries due to low oxygen levels.
• Group 4: Caused by blood clots in the pulmonary arteries.
• Group 5: Associated with other disorders like sarcoidosis or blood cancers that affect pulmonary pressures.

As the disease progresses, complications like heart enlargement, blood clots, and arrhythmias may develop. In severe cases, pregnancy can be life-threatening for people with pulmonary hypertension.

What is Regular Hypertension?

Regular hypertension, or systemic hypertension, refers to high blood pressure in the systemic arteries that carry oxygenated blood from the heart to the rest of the body. Unlike pulmonary hypertension, which affects the lungs, regular hypertension primarily affects the left ventricle of the heart, which must pump harder to circulate blood through the body.

Systemic hypertension is typically measured as two numbers: systolic (the top number) and diastolic (the bottom number), for example, 120/80 mmHg. A blood pressure consistently higher than 140/90 mmHg is classified as stage 2 hypertension. Like pulmonary hypertension, regular hypertension can be symptomless, which is why routine blood pressure checks are important for early detection.

Diagnosing Pulmonary and Regular Hypertension

The key to managing both types of hypertension is early diagnosis. Pulmonary hypertension requires specialized tests, as its symptoms often mimic those of other heart or lung conditions. Common diagnostic methods include:

• Echocardiogram: To visualize heart structure and estimate pulmonary artery pressure.
• Chest X-ray: To check for changes in heart size.
• CT scan: To detect lung blood clots.
• Right heart catheterization: To measure pulmonary pressures directly.

In contrast, regular hypertension is often diagnosed using a standard blood pressure cuff, with repeated high readings confirming the condition. Additional tests, such as bloodwork or kidney function tests, may be used to check for complications of high blood pressure.

Treating Pulmonary Hypertension

Treatment for pulmonary hypertension focuses on improving blood flow in the pulmonary arteries. Medications such as prostacyclins, endothelin receptor antagonists, and phosphodiesterase inhibitors work to dilate the arteries and reduce pressure. Oxygen therapy, diuretics, and heart-strengthening drugs like digoxin can also help manage symptoms. In advanced cases, surgical interventions such as atrial septostomy or a lung transplant may be necessary.

Managing Regular Hypertension

Managing regular hypertension involves addressing lifestyle factors that contribute to high blood pressure. For some, diet changes, weight loss, exercise, and reducing alcohol intake can help lower blood pressure. If lifestyle modifications aren’t enough, medications such as diuretics, ACE inhibitors, and beta-blockers are prescribed to control blood pressure over time.

Key Differences Between Pulmonary and Regular Hypertension

While both pulmonary and regular hypertension involve high blood pressure, they affect different parts of the circulatory system and require different treatment approaches:

• Location of impact: Pulmonary hypertension affects the lungs’ arteries, while regular hypertension impacts systemic arteries that supply the entire body with oxygenated blood.
• Pressure differences: Pulmonary artery pressures are naturally lower than systemic arterial pressures, so elevated pulmonary pressure is more significant.
• Contributing factors: Pulmonary hypertension is often linked to lung and heart problems, whereas lifestyle factors such as diet and exercise are major contributors to regular hypertension.
• Consequences: Pulmonary hypertension can lead to rapid right heart failure, while regular hypertension causes slower, systemic changes like stroke or kidney disease.
• Treatment focus: Pulmonary hypertension treatment centers on opening narrowed blood vessels, while regular hypertension management focuses on improving risk factors and using medications to regulate blood pressure.

Understanding the distinction between these two types of hypertension is essential for proper diagnosis and treatment. While they share some similarities, the causes, complications, and management of each condition differ greatly.