Pulmonary Hypertension And Sleep Apnea.
The rare and severe lung disease called pulmonary hypertension (PH) affects the pulmonary arteries, causing high blood pressure. The pulmonary arteries transport the blood from the right heart ventricle to the lungs, but when affected by the disease, they become narrowed and thickened. The hearts of patients with pulmonary hypertension need to work harder to properly pump the blood, which make them enlarged, weakened and more susceptible to complications like right heart failure.
The diagnosis, management and prognosis of pulmonary hypertension are closely related to the causes of the disease. The problem is they are not always completely understood. It can develop as consequence of alterations in the cells that line the pulmonary arteries with or without a known cause for it, or as result of another original condition. Sleep apnea, a potentially severe sleep disease that makes patients stop breathing repeatedly for short periods of time while sleeping, is among the most common primary diseases that cause pulmonary hypertension.
Development and Diagnosis Of Pulmonary Hypertension And Sleep Apnea
Sleep apnea is a well-known contributor for the development of cardiovascular disease and pulmonary hypertension. This is correlation happens since the disease increases the risk of hypertension, pulmonary vascular disease, ischemic heart disease, stroke, congestive heart failure and arrhythmias. The study “Obstructive sleep apnea and pulmonary hypertension” focused on the reasons for this and concluded that the increase in pulmonary artery pressure is related to repetitive nocturnal arterial oxygen desaturation and hypercapnia, and large intrathoracic negative pressure swings.
Since the disease causes these effects repeatedly, it results in pulmonary vascular remodeling, sustained pulmonary hypertension and right ventricular hypertrophy, as demonstrated in rodents. In addition, both conditions share a series of risk factors, including age, gender, obesity, diabetes and hypertension. However, the American College of Chest Physicians (ACCP) does not considers screening for pulmonary hypertension needed for patients with sleep apnea, unless there are suspicions, which can delay diagnosis and treatment, as well as accelerate the development of more severe consequences.
Prognosis and Treatment Of Pulmonary Hypertension And Sleep Apnea
Between 17 and 53 percent of the patients who suffer from sleep apnea, also develop pulmonary hypertension, according to a 2004 American College of Chest Physicians consensus panel. Due to the development of both conditions, patients become more susceptible to the occurrence of heart failure, stroke or sudden death. However, when diagnosed properly and early, there are treatments that can help reduce the symptoms of both conditions as well as the risk of death.
The study “Obstructive Sleep Apnea, Cardiovascular Disease, and Pulmonary Hypertension” explains that continuous positive airway pressure (CPAP) is effective in the treatment of these patients, being able to significantly improve cardiac function, sympathetic activity and quality of life. Not only can this treatment help reduce pulmonary artery pressure in patients with pulmonary hypertension and sleep apnea, but it also increases left ventricular function and functional capacity, and decreases the norepinephrine levels.
