Pulmonary Arterial Hypertension or PHA is a type of high blood pressure disorder that mainly affects the arteries connecting the heart and the lungs. These arteries are responsible for pumping fresh oxygenated blood from the lungs into the chambers of the heart that further pump this blood to all parts of the body. A blockage or narrowing of blood vessels in these arteries results in increased blood pressure. There is no cure for PHA; however, there are medications and a few viable PAH treatments that can help manage the condition and improve the quality of life.
Medications for PAH treatment
PAH is a serious condition, and doctors prescribe a combination of the following class of medications.
- Blood vessel wideners (Vasodilators)
Vasodilators are commonly prescribed for PAH treatment and widen the blood vessels present in the vital arteries of the body. This way, oxygenated blood can be efficiently pumped via the lungs and circulated throughout the body using the network of arteries. Vasodilators are available in the form of inhalants, IV injections, and even oral tablets. Depending on the severity of the condition, doctors vary the dosage accordingly. Some people prefer the use of nebulizers to inhale and deliver the dosage directly into the lungs. Alternatively, the IV injection delivered through the vein is just as effective in delivering the dosage directly to the blood vessels. The prescribed IV injections must be taken frequently, and the medication is controlled by a small battery-powered pump that delivers doses at set intervals. - Blood thinners (anticoagulants)
Blood clots increase the risk of pulmonary hypertension, and this is one of the reasons doctors alternatively suggest the use of blood thinners to dilute the blood vessels. However, anticoagulants are not the preferred choice of medication for PAH Treatment. One must constantly monitor their health after using prescribed blood thinners by frequently visiting the doctor and getting blood tests to check the effect of the medication. One of the major problems associated with the use of blood thinners is the increased risk of bleeding. The diluted blood vessels no longer possess the ability to clot and plug a wound. Further, one must also make changes in diet and lifestyle. - Endothelin receptors
These are oral medications that help counter the effects of endothelin, a substance that is naturally present in blood vessels. Excess endothelin can result in a buildup on the walls causing the blood vessels to narrow. Narrow blood vessels further affect the oxygen flow to the rest of the body. Endothelin receptors are an antagonist class of medication that interferes with the production of this substance and prevent the narrowing of blood vessels.
For severe cases, surgery is the best option in PAH treatment. Depending on the type of PAH and how critical the condition is, doctors suggest the following type of surgery.
- Pulmonary Endarterectomy
If one has chronic thromboembolic pulmonary hypertension, then surgeons can suggest a pulmonary endarterectomy. In this procedure blood clots are removed via operation. - Angioplasty
Alternatively, an angioplasty can be done to relieve the blood pressure by pushing out the blockage in the arteries using a small inflated balloon. Angioplasties are done more commonly for restoring blood flow to the lungs and lowering blood pressure. - Open heart surgery
Medically referred to as Atrial Septostomy, the procedure helps relieve the pressure inside the right chamber of the heart and improves the organ’s blood pumping function. Open heart surgeries are usually the last resort, as several complications can arise during and after the surgery. - Complete organ transplant
Note that organ transplants are done in very rare and severe cases only. This can be a lung transplant or a heart transplant to restore effective blood pumping. There is always the inherent risk of the body rejecting the new organ.
It is always advisable to seek expert medical consultation at the earliest and follow up with specialists to understand the impact of different PAH treatments on one’s lifestyle.
