Primary Pulmonary Hypertension

Pulmonary hypertension occurs when blood circulation through your lungs is restricted by narrowed blood vessels. To maintain blood flow through these narrowed blood vessels pulmonary artery pressure increases. Pulmonary hypertension can occur by itself but is often caused by an existing disease. It is a rare condition that mostly affects women in their 30s or 40s.

Signs and Symptoms

The most common symptom is shortness of breath with exercise progressing to shortness of breath while at rest. Other symptoms are:

• Getting tired easily
• Fainting
• Cough
• Chest pain
• Swelling of the lower extremities
• Coughing up blood

What Causes It?

Many cases have no known cause. Some conditions that are associated with pulmonary hypertension include the following.

• Congenital heart disease
• Mitral stenosis or regurgitation
• Certain kinds of lung disease
• Obesity especially with sleep apnea
• Chronic obstructive pulmonary disease (COPD)
• Cocaine abuse
• Use of dexfenfluramine and other diet drugs

What to Expect at Your Provider's Office

Your health care provider will give you a thorough examination and order laboratory tests to diagnose your condition.

Treatment Options

Treatment Plan

If your pulmonary hypertension is the result of another disease that disease must be treated. Pulmonary hypertension sometimes results from diet pills. You will need to stop all such medication. It is important to avoid excessive physical stress or exercise. Supplemental oxygen is sometimes necessary. If your disease is seriously progressed you may be advised to have a lung or a lung–heart transplant.

Drug Therapies

Prescription

• Vasodilators—dilate the blood vessels; taken orally or by inhalation for those with no underlying disease; various side effects
• Anticoagulants—such as warfarin if the primary disease is thromboembolic pulmonary disease; various side effects
• Diuretics—for right ventricular failure; various side effects

Over the Counter

N/A

Complementary and Alternative Therapies

Nutrition

• Coenzyme Q10 (100 mg twice a day) supports cardiac function is an antioxidant and oxygenates tissues.
• L-Carnitine (500 mg three times per day) improves endurance and is needed for efficient cardiac function.
• Magnesium aspartate (200 mg two to three times per day) increases efficiency of cardiac muscle and decreases vascular resistance.
• Potassium aspartate (20 mg per day) improves the ability of the heart muscle to contract.
• Vitamin E (400 IU per day) is an antioxidant and protects the heart.
• Vitamin C (1 000 to 1 500 mg three times per day) is an antioxidant improves vascular integrity and stimulates immune function.
• Taurine (500 mg twice a day) enhances cardiac function.
• Selenium (200 mcg per day) is a cardioprotective antioxidant.
• Choline (250 to 500 mg per day) and inositol (150 to 200 mg per day) positively affect heart and lung activity.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Combine the following herbs in equal parts in tincture form and take 30 drops three to four times per day.

• Hawthorn (Crataegus oxyacantha) helps your heart work more efficiently without making it work harder. Strengthens the integrity of and mildly dilates blood vessels.
• Garlic (Allium sativum) helps you cough up mucus lowers blood pressure stimulates your immune system and helps prevent hardening of the arteries.
• Rosemary (Rosemarinus officinalis) strengthens cardiac function prevents hardening of the arteries prevents spasms and improves circulation to the lungs.
• Linden flowers (Tilia cordata) prevents spasms lowers blood pressure prevents hardening of the arteries relaxes your respiratory system and helps you cough up mucus. Also stimulates immune function.
• Ginkgo (Ginkgo biloba) improves peripheral blood flow and decreases platelet aggregation.
• Indian tobacco (Lobelia inflata) stimulates respiratory function reduces spasms and lowers blood pressure. Used in high doses this herb can have toxic side effects. Using small amounts in a formula (one fourth or less) will minimize the risk of toxicity.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Caster oil pack. Apply oil directly to chest cover with a clean soft cloth and plastic wrap. Place a heat source over the pack and let sit for 30 to 60 minutes.

Contrast hydrotherapy. Alternate hot and cold applications to the chest. Alternate three minutes hot with one minute cold and repeat three times. This is one set. Do two to three sets per day. For very sick patients use cool and warm applications to decrease the contrast.

Steams. Using three to six drops of essential oils in a humidifier vaporizer atomizer or warm bath will stimulate respiration and circulation. Consider eucalyptus rosemary thyme or lavender.

Acupuncture

May support treatment of symptoms through an increase in circulation.

Following Up

The prognosis for pulmonary hypertension is generally poor.

Special Considerations

For the most part women who have primary pulmonary hypertension should not get pregnant because the condition is dangerous for both mother and baby.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset England: Grace Publishers; 1995:195 270 276 376.

Bordow RA Moser KM. Manual of Clinical Problems in Pulmonary Medicine. 4th ed. Boston Mass: Little Brown; 1996:304–311 353 424 431–434.

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998:1466–1468.

Fishman AP Elias JA Fishman JA et al. Fishman's Pulmonary Diseases and Disorders. 3rd ed. New York NY: McGraw-Hill; l998: 1261–1296.

Hinshaw HC Murray JF. Disease of the Chest. 4th ed. Philadelphia Pa: WB Saunders; 1980:684–697.

Woodley M Whelan A. Washington Manual of Therapeutics. 27th ed. Boston Mass: Little Brown; 1992:211–212.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.