Environmental irritants that include cigarette smoke, air pollution, workplace fumes and dust can lead to chronic obstructive pulmonary disease that reduces air flow in and out of the lungs.
COPD can lead to Group 3 pulmonary hypertension caused by low oxygen levels and:
- Loss of elasticity of the airways and air sacs (alveoli)
- Destruction of the walls between the air sacs
- Inflammation (swelling) of the walls of the airways
COPD is most frequently caused by irritants that damage the lungs and the airways. In the U.S., the most common irritant is cigarette smoke. Secondhand smoke, chemical fumes, and gas or dust from the workplace or environment also can cause COPD.
COPD symptoms include difficulty breathing, frequent coughing, mucus (sputum) production and wheezing.
Common types of COPD
Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs to most of the lungs. A common symptom is a persistent cough with mucus production.
Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed. The most common symptom is shortness of breath with activity.
How PH develops from COPD
Mild pulmonary hypertension is a common complication of COPD. PH usually gets worse with exercise, sleep or worsening COPD. Damage to and changes in the pulmonary vessels in COPD are the main causes of an increase in pulmonary pressure.
Specifically, hypoxia (low oxygen levels), inflammation and destruction of small blood vessels cause PH to develop. Frequently, PH forces the right side of the heart to work harder, which subsequently results in right-sided heart failure.
While many patients with COPD lead long lives without significant symptoms, PH is a serious and complex complication that requires further evaluation.
Symptoms related to COPD-associated PH
- Increased shortness of breath with activity
- Increased fatigue
- Swelling of the ankles, legs or abdomen
- Chest discomfort or pain
- Light-headedness
COPD symptoms can make exercise difficult, and COPD-associated PH can cause additional challenges with physical activity. It is important to report any changes in current physical abilities to your doctor.
Diagnosing PH
These are among the tests that may be conducted to diagnose PH:
- Echocardiogram
- Pulmonary function tests
- Ventilation-perfusion (V/Q) scan
- Natriuretic peptide tests
- Right heart catheterization
Treatment options
There is little information about the effectiveness of PH-specific therapies for COPD-related PH. However, all patients can benefit from appropriate COPD treatments, including:
- Paying special attention to fluid balance with a low-sodium diet and diuretics (water pills).
- Using supplemental oxygen as directed.
- Using optimal bronchodilator inhalers.
- Treating sleep apnea.
- Referral for lung transplantation work-up in eligible patients.
Manage your COPD-related PH
After doctors have established an effective medical approach and treatment plan, many patients show significant improvement, often in conjunction with doctor-prescribed cardiopulmonary rehabilitation.
- Supplemental Oxygen Therapy
Supplemental oxygen helps increase oxygen levels in the blood and reduce symptoms such as fatigue and shortness of breath.
- Managing Salt and Sodium Consumption
Managing sodium in your diet is one of the most effective ways to reduce water retention, which reduces strain on your heart.
- Pulmonary Hypertension Related to Sleep Apnea
Mild-to-moderate pulmonary hypertension is a common complication of sleep apnea, a sleep disorder in which breathing repeatedly stops and starts while one is asleep.
- Lung or Heart-Lung Transplant
Lung or heart-lung transplantation provide an option for some individuals who are no longer responding significantly to available medical therapies for pulmonary hypertension. Transplantation may extend and improve a patient’s quality of life but requires life-long care and medications.
Find a PH Care Center
Although there are no FDA-approved medications to treat COPD-associated PH, there often are clinical trials that study the benefits of PH medications in this population. Patients should visit an expert PH center for a detailed assessment and possible clinical trial enrollment.
Find a PHCCDownload or order a brochure
Information on PH and COPD is one of a series of PH& brochures available to download as a PDF or to order as a printed brochure.
PH & COPD
