JOHANNESBURG, July 01, 2024 – Pulmonary Hypertension (PH) impacts around 1% of the global population which, presently, means that around 78 million people are known to suffer from it. Importantly, around eighty percent of patients live in developing countries like South Africa. (1)
The disease is more than simply high blood pressure. It’s a condition that sees arterial pressure impact the respiratory system, in other words, the lungs, and frequently the right-hand side of the heart. In one form of pulmonary hypertension, called pulmonary arterial hypertension (PAH), blood vessels in the lungs become narrowed or block, or even destroyed. “This means that the pressure in the lungs is increased because blood flow is slowed. This extra effort eventually causes the heart muscle to weaken and, eventually fail,” said Portia Mmenu of Janssen South Africa Medical Affairs. (2)
“The disease process of PH is like a domino effect that begins at a microscopic level but has macroscopic consequences,” Mmenu said. And it is often misdiagnosed and confused with other conditions like asthma. “Symptoms such as shortness of breath, dizziness, and fatigue can lead healthcare professionals toward a preliminary asthma diagnosis,” she noted (1). “However, when typical asthma treatments fail to relieve these symptoms, further investigation often reveals PH,” she added.
Other symptoms, which may or may not manifest at different times, include shortness of breath, at first while exercising and later even when sedentary. A blue or grey tinge, dependent on skin colour, becomes visible along with dizziness or fainting spells, pressure on the chest, swelling in the belly, leg, and ankle area along with chronic fatigue. (2) “However,” said Mmenu, “consulting with a healthcare professional when encountering any of these symptoms is critical. They are like detectives, interrogating the body and investigating symptoms to develop a diagnosis, and early diagnosis is the key to better care.”
PH is mostly diagnosed between ages thirty and sixty and, as people grow older, lifestyle choices also impact risk factors. Mmenu said that contributing risk factors include obesity, smoking, living at high altitude and exposure to asbestos. (2)
In all cases, causes of PH can be varied, said Mmenu, and could include the use of certain medications such as some weight loss remedies and illegal drugs like cocaine methamphetamine. “It could be hereditary or be associated with heart problems at birth,” Mmenu added, “while other health conditions like lupus, chronic liver disease or scleroderma (inflammation and thickening of the skin) could also play a role”. Left hand side heart failure could also cause rocketing blood pressure and, concomitant to the additional strain on the right and side of the heart, weakness, and eventual failure. (2)
Developing countries are at greater risk, said Mmenu because there are many added contributing factors like HIV, tuberculosis and rheumatic and congenital heart disease incidences that are conducive to the development of PH. (3)
“Education and awareness are the most powerful tools we have against diseases like PH,” said Mmenu. “As people age, it becomes increasingly important to test for PH during annual health checkups,” she noted. “Early intervention leads to better management outcomes. A multidisciplinary approach ensures comprehensive care, from initial symptom management to advanced therapies aimed at treating the underlying causes of PH. This not only saves lives but adds quality of life into the equation”, said Mmenu.
Sources:
- European Respiratory Review. New trends in pulmonary hypertension. https://err.ersjournals.com/content/32/167/220211.
- Mayo Clinic. Pulmonary hypertension. https://www.mayoclinic.org/diseases-conditions/pulmonary-hypertension/symptoms-causes/syc-20350697.
- PMC. Pulmonary hypertension in the developing world: Local registries, challenges, and ways to move forward. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590932/#:~:text=Limited%20reports%20suggest%20that%20the,congenital%20heart%20diseases%2C%20pulmonary%20tuberculosis.