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What's The Link Between Asthma And Pulmonary Hypertension?
Asthma and pulmonary hypertension are separate conditions that need different treatments. But because they share some symptoms, such as chest discomfort and shortness of breath, misdiagnosis is common.
Asthma and pulmonary hypertension (PH) both affect your lungs, though in different ways. Although they share some symptoms, they also have several distinguishing symptoms. It's also possible to have asthma and PH at the same time.
Read on to learn more about asthma and PH, including their similarities, differences, possible links, and overall outlook.
Asthma and PH both affect your lungs, but they do so in different ways.
Asthma affects the bronchial tubes, or airways, in your lungs, making them inflamed. Both acute and chronic inflammation can lead to airway constriction, causing classic symptoms, such as coughing and wheezing.
PH is a type of high blood pressure (hypertension) that affects the blood vessels between your lungs and heart. Unlike asthma, which affects your airways, PH affects the arteries in your lungs. Pressure can build up and cause these blood vessels to constrict, leading to low blood oxygen levels in your body.
Although wheezing and coughing are linked with asthma, PH is more likely to cause fatigue and dizziness. Both can cause shortness of breath and chest pain.
Asthma is extremely common, affecting about 7.7% of people in the United States. PH is relatively rare, though experts may underestimate its exact incidence.
There are five "groups" or underlying causes of PH. Lung conditions, low oxygen levels in the body (hypoxia), and obstructive sleep apnea are included in Group 3. Asthma is one possible cause of hypoxia, as it can cause periods of hypoventilation.
Still, there's no definitive link between asthma and PH. More research is needed to determine whether people with asthma have a higher chance of developing PH.
It's possible to mistake PH and asthma for each other because of their similar symptoms. Each condition can cause lung-related symptoms, such as chest discomfort and shortness of breath.
However, with asthma, you're more likely to experience more breathing-related difficulties, such as coughing and wheezing. This is due to asthma's direct influence on your airways.
PH, on the other hand, can cause other signs and symptoms throughout the body due to increased arterial pressure in your lungs and resulting low blood oxygen (hypoxemia). Unlike people with asthma, people with PH may experience:
Experts also think that doctors may underdiagnose PH because of symptoms they could mistake for asthma or anxiety. Such misdiagnoses can prevent people from getting the treatments they need to prevent heart failure and other life threatening complications.
Although lung conditions may increase the likelihood of PH development in some people, asthma and PH are separate conditions that need different treatments.
Asthma treatments help reduce symptoms and underlying inflammation. Examples include:
PH treatment focuses on slowing disease progression and improving your overall quality of life. This may involve inhaled or oral medications to dilate blood vessels, such as:
Unlike with asthma, severe PH treatment may involve a lung transplant. A doctor may also recommend a heart transplant in cases of significant damage to the right side of your heart.
Asthma is a lifelong condition that requires a combination of management, trigger avoidance, and treatment.
On the flip side, PH may be fatal, especially without prompt diagnosis and treatment. It's important to contact a doctor if you're experiencing any possible signs and symptoms of this condition. It's best not to assume your symptoms are from asthma, as this may delay necessary treatment.
Without treatment, PH gradually weakens the arteries in your lungs, causing increased lung pressure. These effects also make your heart work harder, eventually increasing the likelihood of right sided heart disease and heart failure.
Consider the following frequently asked questions about asthma and PH. You may wish to discuss these further with a doctor if you have one or both of these conditions.
Does albuterol help with pulmonary hypertension?Albuterol is a common asthma treatment. It's a bronchodilator, which means it widens your airways. Bronchodilators like albuterol aren't a first-line treatment for PH.
However, research is ongoing regarding using albuterol to help with chest tightness and breathing problems related to PH.
How does asthma affect lung pressure?PH can increase blood pressure within your lungs' arteries. Asthma doesn't cause the same type of pressure.
Asthma can, however, cause chest pain and tightness that can feel like pressure in your lungs. Unlike PH, asthma causes chest discomfort due to airway inflammation and chronic cough.
What lung conditions cause pulmonary hypertension?Not all cases of PH are due to lung disease. But certain lung conditions, including chronic obstructive pulmonary disease, pulmonary fibrosis, and emphysema, can be a cause. Asthma may also contribute to PH since it may cause hypoxia, or a lack of oxygen in the tissues of your body.
Doctors classify PH due to chronic lung conditions as Group 3 PH.
Asthma is a chronic lung condition that affects your airways. PH is a separate condition that affects your lungs and heart. Because they share some symptoms, it's possible to mistake them for each other, sometimes leading to misdiagnosis and delayed treatment.
If you have any symptoms of either condition, it's important to contact a doctor for a prompt and accurate diagnosis.
Senior Living: Understanding The Signs And Symptoms Of Heart Failure
By Dr. Andrew Yoon, Guest columnist
Heart failure is the leading cause of hospitalizations in people older than 65.
Most seniors who experience heart failure already have a prior history of chronic cardiovascular disease. This is why it's important for seniors to understand what heart failure is and to know its signs and symptoms to catch the disease in the early stages.
The earlier heart failure is found, after all, the easier it is to treat.
As we age, our arteries become stiffer and less flexible, causing our blood pressure to increase. To compensate for this increase in blood pressure, the heart pumps harder and the walls of the heart thicken to help increase its blood output. Unfortunately, the heart can't keep up this hard work forever — and it eventually dilates and weakens.
As the heart's structure gradually changes, the symptoms of heart failure build up slowly and are not immediately obvious, leaving many patients unaware they are experiencing heart failure for months or years, until their heart is severely weak. For this reason, it is important for seniors to maintain regular checkups with their doctor to monitor their heart.
In other cases, symptoms of heart failure can occur suddenly, like after a large heart attack, which permanently damages the structure and function of the heart.
If you are experiencing symptoms of heart failure, talk with your doctor immediately. Symptoms of heart failure may include:
The American Heart Association, in collaboration with the American College of Cardiology, has identified four stages of heart failure to help seniors know where they stand in the disease process:
It is important to know where you are in these four stages in order to take a proactive approach with your doctor in preventing the progression of heart failure from occurring as you age.
Maintaining a healthy lifestyle is one of the most effective ways to prevent heart failure, according to the American College of Cardiology and the American Heart Association. The earlier you can implement lifestyle changes, the greater the chance you have of maintaining a healthy heart.
The first action everyone can take to maintain a healthy lifestyle is to stay active. Adults aged 65 and older need at least 150 minutes a week of moderate-intensity activity (like walking). Ask your doctor to discuss what activities best fit your abilities.
In addition to exercise, it's important to also follow a healthy diet to avoid heart failure. As you age, be sure your meals are giving you maximum health benefits by following these guidelines:
Every person's body reacts differently to diet and exercise, so it is important to talk with your doctor to create a fitness regimen and nutrition plan that works best for you.
Dr. Andrew Yoon serves as the medical director of heart failure at the MemorialCare Heart & Vascular Institute at Long Beach Medical Center. He is board-certified in advanced heart failure and transplant cardiology; cardiology; and internal medicine. He joined Long Beach Medical Center in 2018.
UPMC Doctor Involved In Research To Treat Pulmonary Hypertension With Cancer Medicines
Allison Dsouza was unable to walk a short distance without becoming winded.
The Munhall resident's trouble breathing led to a diagnosis of pulmonary hypertension, high blood pressure in the blood vessels in the lungs.
Pulmonary hypertension is a rare, incurable lung disease.
She has what's called "idiopathic" pulmonary hypertension, which means there's no known cause.
Her current treatment involves Remodulin, a prescription medication, that is delivered 24/7 by a pump under the skin. It's a drug that works by widening the blood vessels and can help with symptoms of pulmonary hypertension.
But it doesn't cure the condition.
Courtesy of Allison Dsouza
Allison Dsouza of Munhall at the PHenomenal Hope 5K poses for a photo with nurse practitioner Jen Kliner and a former physician at UPMC, Dr. Patty George. The annual event on Pittsburgh's North Side raises funds for research for pulmonary hypertension.
Within months of starting treatment, Dsouza was able to walk in The PHenomenal Hope 5K and 1 Mile walk, an annual event to raise funds for research for pulmonary hypertension. She also has started playing polo.
"The treatments are phenomenal, but they're also a huge burden on life," said Dsouza, who was diagnosed as a high school senior. "They can be painful."
They can be and there can be other complications, such as infection from those patients who are on an intravenous treatment, said Dr. Stephen Chan, professor of medicine and director of the Vascular Medicine Institute at the University of Pittsburgh and UPMC.
"The medication is lifesaving, but the side effects can kill you," Chan said. "And for some people, the therapies don't work."
That's why he is part of a team of researchers at the University of Pittsburgh School of Medicine and Prairie View A&M University in Texas who have been working to identify cancer drugs that show promise for treating pulmonary hypertension.
Pulmonary hypertension and cancer share numerous features so molecular data from cancer studies could be leveraged to predict which cancer drugs may also target pulmonary hypertension, Chan said.
A study published in Science Advances journal identified two candidate cancer drugs. They improved markers of the disease in human cells and rodents, Chan said.
The findings also support broader use of this drug-repurposing platform for other non-cancerous conditions that don't yet have effective treatments, according to the journal.
The drugs targeted pathways involved in human lung cells. When researchers gave one of the drugs to rodents with pulmonary hypertension disease symptoms were reversed, Chan said.
"In fact when we gave either drug to rodents, pulmonary hypertension was reversed," Chan said.
Courtesy of UPMC
Dr. Stephen Chan, professor of medicine and director of the Vascular Medicine Institute at the University of Pittsburgh and UPMC, is part of a team of researchers looking at using cancer drugs to treat pulmonary hypertension.
Repurposing drugs can cut downtime and the cost of developing treatments for rare diseases, said Chan.
"Pulmonary hypertension is an example of a rare disease where there is an unmet need for new treatments, given its devastating consequences," said Chan. "The goal is to get treatments to patients faster."
Pulmonary hypertension is thought to be triggered by environmental and genetic factors that damage the cells that line blood vessels, leading to inflammation.
Current medications dilate or relax these blood vessels, which can give relief from symptoms and prolong the time it takes for the disease to progress, but they're not curative, Chan said.
Chan and Seungchan Kim, chief scientist and executive professor of electrical and computer engineering at Prairie View A&M, analyzed gene data from cancer cell lines exposed to cancer therapeutics and assessed rewiring of gene networks associated with drug responses in these cells.
"When we overlay these networks with pulmonary hypertension-specific gene networks, we can predict which drugs may be effective in treating pulmonary hypertension," Kim said in a statement.
When Chan and Imad Al Ghouleh, Ph.D., assistant professor of medicine at Pitt, gave one of the genes to mice and rats with pulmonary hypertension, disease symptoms were reversed.
Researchers have applied for a provisional patent and plan to move into clinical trials.
According to Chan, the applications of this study go far beyond pulmonary hypertension. They may be able to repurpose existing cancer drugs for the treatment of other rare and emerging diseases.
Dsouza, 24, is a registered nurse in the cardiac Intensive Care Unit at UPMC Children's Hospital of Pittsburgh in Lawrenceville. Prior, she had cared for pulmonary hypertension patients in the UPMC Lung Transplant Program at UPMC Presbyterian in Oakland.
"Allison is young and vibrant," said Chan. "She has so much life ahead of her and we want to help patients like Allison."
Dsouza said she tries to do as much as she can, and her diagnosis is a reason she became a nurse.
"It's all worth it to me," she said. "I love working with patients, especially those who have pulmonary hypertension because I know what they are going through. I love being a part of their lives and helping them. Dr. Chan and all the researchers are wonderful. You don't find many doctors who know about this. Their work is helping people like me breath a little easier."
JoAnne Klimovich Harrop is a TribLive reporter covering the region's diverse culinary scene and unique homes. She writes features about interesting people and a weekly column about things to do in Pittsburgh. The Edward R. Murrow award-winning journalist began her career as a sports reporter. She has been with the Trib for 26 years and is the author of "A Daughter's Promise." She can be reached at jharrop@triblive.Com.
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