High blood pressure, BP, or hypertension is a very common condition that occurs due to the high force of blood against the artery walls. It is a long-term condition that can lead to other diseases. Pulmonary hypertension (PH) is a type of hypertension in the lungs’ arteries and the right side of the heart. Pulmonary arterial hypertension (PAH) is a sub-group of PH. PH and PAH are two different conditions with different causes and treatments.

Read on to know the differences between the two conditions.

1. Cause of PH and PAH
PH: Hypertension in the lungs can happen due to many causes. Whatever the cause, such instances of hypertension are referred to as pulmonary hypertension. Possible causes of PH are congenital heart disease, coronary artery disease, liver disease, blood clots, and lung diseases like emphysema and genetics. PAH is one of the causes of pulmonary hypertension.

PAH: The walls of the arteries in the lungs become tight and stiff. This forces the lungs to work harder, resulting in high blood pressure called PAH. Thickening of the artery walls is the only cause of PAH.

2. Risk factors of PH and PAH
PH: PH can happen to anyone, including children. The risk increases with age. Non-Hispanic, African-American people, and women are at a higher risk.

PAH: Thickening and stiffening of artery walls leading to PAH can happen due to family history, a combination of obesity and sleep apnea, high altitude living, and illegal drug use. People using appetite-suppressant medication are at a high risk of PAH.

3. Symptoms of PH and PAH
PH: Difficulty in breathing, fatigue, dizziness, chest pain, palpitations, and swelling in the ankles and abdomen are symptoms of PH. Lips and skin may turn bluish as well.

PAH: PAH has symptoms similar to PH, except that the symptoms may be more severe.

4. Diagnosis of PH and PAH
PH: It is a difficult condition to diagnose even during periodic physical exams. Based on symptoms, doctors use blood tests, X-rays, CT scans, ECG, ECHO, and other diagnostic tests to diagnose PH. They may do an open lung biopsy to remove tissue from the lungs if they cannot confirm the cause of hypertension.

PAH: Though other tests can suggest PAH, as per WHOs guidelines, right heart catheterization is the only official test that can diagnose PAH.

5. Treatment of PH and PAH
PH: PH cannot be cured, and hence treatment aims to treat the underlying cause of PH. Doctors hope to improve the symptoms and slow down the progression of the disease.

PAH: PAH too has no cure. Doctors treat PAH with oral, inhaled, intravenous, or subcutaneous medication to enlarge the blood vessels. They also prescribe diuretics to treat swelling and fluid retention and anticoagulants to prevent blood clots. Patients with severe symptoms may carry a portable oxygen tank. For those with severe symptoms, doctors may recommend a single or double lung transplantation.