The Definition of Pulmonary Hypertension (PH) | What is PH?

In 2022, the European Respiratory Society (ERS) and the European Society of Cardiology (ESC) released fresh guidelines for diagnosing pulmonary hypertension (PH). These guidelines provide a more precise and accurate way to identify PH.

Key Changes:

  • New PH Definition: The new way uses a measurement called mean pulmonary arterial pressure (mPAP). If it’s over 20 mmHg during rest (measured by a test called a right heart catheterization), it’s considered PH. Before, it had to be over 25 mmHg.
  • Specific PAH Definition: The guidelines also better define pulmonary arterial hypertension (PAH), the most common type of PH. PAH is now defined as:
    • mPAP > 20 mmHg
    • pulmonary vascular resistance (PVR) > 2 Wood Units (WU)
    • pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg

Read about the differences between PH & PAH.

Benefits of the New Guidelines:

  • Earlier Diagnosis, Earlier Treatment: The lower mPAP threshold allows for earlier identification of PH patients. Finding PH sooner allows doctors to start treatment quicker, and aim for better outcomes.
  • Improved Classification: The refined PAH definition facilitates more accurate classification of PH subtypes, leading to better-targeted treatment approaches.
  • Clearer Treatment Guidance: The updated guidelines offer clearer recommendations for PH management based on the specific diagnosis.

Important Note:

  • These guidelines are for doctors and other healthcare workers. They are not meant for people to diagnose or treat themselves for PH.
  • If you suspect you might have PH, consult a doctor immediately.
  • The new definitions do not apply to exercise-induced PH, which is a separate condition. 

Additional Resources: Full 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.