Borderline Pulmonary Hypertension

High pressure of blood in the pulmonary circulation is termed pulmonary hypertension. The blood pressure is high in the arteries which go to the lungs but in the arms and the rest of the body it is normal or low. Pulmonary hypertension is different from essential hypertension and is the result of some disease of the lungs or heart. Pulmonary hypertension can be termed a disorder of the blood vessels in the lungs. When the blood pressure in the pulmonary arteries (those vessels carrying blood from the heart to the lungs) becomes higher than normal, too much strain occurs on the right side of the heart.

Pulmonary hypertension can be a serious problem. The common symptoms are shortness of breath during some activity or exercise, fatigue, chest pain and fainting. There can be various causes behind pulmonary hypertension. When the exact cause is not known, primary pulmonary hypertension occurs. When the cause is known it is termed secondary pulmonary hypertension.

The common causes of secondary pulmonary hypertension are emphysema and chronic bronchitis or breathing problems. Among the other causes are congestive heart failure, birth defects in the heart, chronic pulmonary thromboembolism or old blood clots in the pulmonary arteries, HIV infection and certain medications. Both primary and secondary pulmonary hypertensions are permanent conditions. However, treatment can provide relief in some people.

When the blood pressure level is within the 'gray zone' i.e. between normal and high, it is termed borderline pulmonary hypertension. It is defined as mildly high blood pressure that is higher than 140/90 mm Hg at certain times and lower than that at other times. In an aged person, a higher systolic blood pressure, between 140 and 160 mm Hg, is considered a borderline case, as long as the diastolic pressure is below 90.

Patients suffering from borderline hypertension need to have their blood pressure taken from time to time. Their end-organ damage also needs to be assessed to establish whether the hypertension is significant. As he or she gets older, a patient with borderline hypertension can develop a sustained or higher level of blood pressure. Naturally, the risk of developing a cardiovascular disease gets increased. Therefore, patients with borderline hypertension have to keep checking their blood pressure and monitor the complications that can occur. When the blood pressure becomes persistently higher, an anti-hypertensive medication is started.

A physical examination is necessary to identify the typical symptoms of pulmonary hypertension. These include altered heart sounds, a loud pulmonic valve closure sound, possible third heart sound and pulmonary regurgitation. Among the other symptoms are an elevated jugular venous pressure, peripheral edema or swelling of the ankles and feet, abdominal swelling due to the accumulation of fluid, hepatojugular reflux and clubbing.

Some other tests are also conducted to confirm the presence of pulmonary hypertension. Among these are pulmonary function tests; blood tests to exclude HIV, autoimmune diseases and liver disease; electrocardiography or ECG; arterial blood gas measurements; X-rays of the chest; and ventilation-perfusion or V/Q scanning. Biopsy of the lung is usually not done. Some researches suggest that physical inactivity can be detrimental to patients suffering from any kind of pulmonary hypertension.

• Matt Thompson
• 04/06/2009, 12:59 PM
• 0 Comments