New Medicines Can Help Lower High Blood Pressure in Lungs
By Paul G. Donohue, M.D.
"To Your Good Health"
DEAR DR. DONOHUE: I am a woman, 81, recently diagnosed with pulmonary hypertension. What is it? What is the treatment? Is it curable?
— A.F.
Hypertension is high blood pressure. "Pulmonary" refers to the lungs. Pulmonary hypertension is high blood pressure in the lungs' blood circulation, most often without high blood pressure in the rest of the body. The lungs are delicate structures. They can't tolerate normal body blood pressure. The blood pressure in the lungs is only one-fifth of body blood pressure.
A rise in lung blood pressure can be secondary to chronic obstructive pulmonary disease — also known as COPD, a combination of emphysema and chronic bronchitis. Heart-valve problems can raise lung blood pressure. Illnesses like scleroderma and lupus can do it also. Or — and often this is the case — it happens without an identifiable cause and is then called idiopathic pulmonary hypertension.
"Cure" is too strong a word for this illness, but control is often possible. Extended-release nifedipine — a medicine also used to control ordinary high blood pressure — can bring down lung high blood pressure, too. This medicine comes in many different brand names. Epoprostenol, a drug given by continuous intravenous infusion, lowers pulmonary hypertension.
Three somewhat-new oral drugs — Tracleer, Letairis and Revatio — have markedly changed treatment of this illness. Revatio is the same medicine used for erectile dysfunction. By some quirk of fate, it also lowers high lung blood pressure, and it's been a godsend for patients with this problem.
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