Pulmonary hypertension (PH) often gets confused with pulmonary arterial hypertension (PAH), leading to misunderstandings about diagnosis and treatment. While both conditions involve high blood pressure in the lungs, their causes and management strategies differ.
PH Explained:
- Represents high blood pressure in the lungs.
- Can arise from various underlying conditions like sleep apnea, lung diseases, and heart issues.
- A symptom: Indicating another underlying health problem.
- Treatment focuses on addressing the underlying cause, potentially lowering pressure in the lungs.
PAH Explained:
- A distinct chronic disease affecting the blood vessels in the lungs.
- Narrowed or blocked arteries hinder blood flow, leading to increased pressure.
- Falls under Group 1 of the WHO classification for PH.
- Requires specialized treatment aimed at managing the disease progression and improving blood flow.
In PAH, these arteries become narrowed, blocked, or destroyed, which slows down blood flow through the lungs and causes blood pressure in the lung (pulmonary) arteries to rise. When the heart has to work harder to pump blood through the lungs, it can put a lot of strain on it. This can end up weakening the heart muscle and eventually lead to heart failure. In PH, another disease is usually responsible for the elevation of the pressured; the blood vessels themselves are not the problem.
Key Differences:
| Feature | PH | PAH |
| Cause | Various underlying conditions | Disease of the lung’s blood vessels |
| Pulmonary Artery Involvement | Not necessarily | Narrowed or blocked small arteries |
| Treatment | Address the underlying cause | Specific medications and therapies |
| Impact | Varies depending on the cause | This can lead to heart failure and other complications |
Importance of Distinguishing PH and PAH:
Misdiagnosis can lead to ineffective or even harmful therapies. Treatment approaches differ. Treating PAH with medications designed for PH can be disastrous.
Early diagnosis is crucial for both conditions.
Identifying the underlying cause of PH allows for targeted treatment, potentially reversing the pressure increase to a significant degree. For example, if the patient has severe sleep apnoea causing the elevation in pulmonary artery pressures, they will be prescribed therapy such as a CPAP mask and machine. Once the condition improves, the pressure in their pulmonary arteries will most likely have decreased.
Managing PAH requires prompt intervention due to its progressive nature.
Popular usage of the terms PH & PAH
PAH is often called PH. Even after the official diagnosis of PAH is made, your doctor may call it PH.
Additional Reading: WHO Classification Of Pulmonary Hypertension (PH)
