Treatment - Pulmonary hypertension

Pulmonary hypertension cannot be cured, but treatments can reduce your symptoms and help you manage your condition.

If the cause is identified and treated early, it may be possible to prevent permanent damage to your pulmonary arteries, which are the blood vessels that supply your lungs.

Treating underlying conditions

If pulmonary hypertension is caused by another condition, such as a heart or lung problem, treatments will focus on the underlying condition.

If pulmonary hypertension is caused by blood clots that block the pulmonary arteries, you may be offered anticoagulant medicines to prevent more clots forming. 

You may also be offered an operation known as a pulmonary endarterectomy.

Specialist centres for pulmonary hypertension

If you have pulmonary hypertension, you'll usually be referred to a centre that specialises in treating this condition. There are 7 centres in England and 1 in Scotland.

They are:

• Great Ormond Street Hospital for Children, London
• Hammersmith Hospital, London
• Royal Brompton Hospital, London
• Royal Free Hospital, London
• Royal Papworth Hospital NHS Trust, Cambridgeshire
• Royal Hallamshire Hospital, Sheffield
• Freeman Hospital, Newcastle
• Golden Jubilee National Hospital, Glasgow

Treatments for pulmonary hypertension

There are many treatments for pulmonary hypertension. Which treatment or combination of treatments you'll be offered will depend on a number of factors, including what type of pulmonary hypertension you have, what's causing it and the severity of your symptoms.

Treatments include:

• anticoagulant medicines – such as warfarin to help prevent blood clots
• diuretics (water tablets) – to remove excess fluid from the body caused by heart failure
• home oxygen therapy – this involves inhaling air that contains a higher concentration of oxygen than normal
• digoxin – this can improve your symptoms by strengthening your heart muscle contractions and slowing down your heart rate

There are also a number of specialist treatments for pulmonary hypertension that help relax the arteries in the lungs and reduce the blood pressure in the lungs.

These medicines may slow the progression of pulmonary hypertension, and may help to control or reduce the symptoms.

Other treatments that are sometimes used are:

• endothelin receptor antagonists – such as bosentan, ambrisentan and macitentan
• phosphodiesterase 5 inhibitors – sildenafil and tadalafil
• prostaglandins – epoprostenol, iloprost and treprostinil
• soluble guanylate cyclase stimulators – such as riociguat
• calcium channel blockers – nifedipine, diltiazem, nicardipine and amlodipine

You can find detailed information about these treatments for pulmonary hypertension on the Pulmonary Hypertension Association UK website.

Surgery and procedures for pulmonary hypertension

Some people with pulmonary hypertension may need surgery. The types of surgery currently used are:

• pulmonary endarterectomy – an operation to remove old blood clots from the pulmonary arteries in the lungs in people with chronic thromboembolic pulmonary hypertension
• balloon pulmonary angioplasty – a new procedure where a tiny balloon is guided into the arteries and inflated for a few seconds to push the blockage aside and restore blood flow to the lung; it may be considered if pulmonary endarterectomy is not suitable, and has been shown to lower blood pressure in the lung arteries, improve breathing, and increase the ability to exercise
• atrial septostomy – a small hole is made in the wall between the left and right atria of the heart using a cardiac catheter, a thin, flexible tube inserted into the heart's chambers or blood vessels; it reduces the pressure in the right side of the heart, so the heart can pump more efficiently and the blood flow to the lungs can be improved
• transplant – in severe cases, a lung transplant or a heart-lung transplant may be needed; this type of surgery is rarely used because effective medicine is available

Pulmonary Hypertension Association UK

Pulmonary Hypertension Association UK is a charity for people with pulmonary hypertension.

The website provides further information and advice about all aspects of the condition, including living with pulmonary hypertension, and support for family and friends.