Learning that you have pulmonary hypertension can be frightening. Like most people, you will probably need a little time to adjust to the news that you have been diagnosed with a serious medical condition. Along with being worried, you may find yourself feeling angry or depressed. That's perfectly natural.

But keep this in mind: Many people with pulmonary hypertension discover that they are able to live active lives, working, raising children, and enjoying life. They don't look sick or even feel sick. As long as they pace their physical activities, they may not feel the symptoms of pulmonary hypertension at all. Even if the condition does cause symptoms that limit what you can do, there are ways to adjust your life so you can go on enjoying your family, friends, hobbies, and other activities.

Following a few simple lifestyle recommendations will help you stay as healthy as you can and control the symptoms of pulmonary hypertension. Some of the suggestions are good advice whether or not you have pulmonary hypertension. Other recommendations are specific to people with pulmonary hypertension. Here's what to consider:

Eat a healthy diet with moderate portions. Abundant evidence shows that what you eat plays a big role in cardiovascular health. Also, talk to your doctor about whether you need to restrict salt and fluids in your diet, and whether you need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Following the familiar guidelines for a heart-healthy diet are especially important, given that your heart is under strain.

Make fresh vegetables and fruit, along with whole-grain breads and cereals, the centerpiece of your menu. Help yourself to lean chicken and fish, and go easy on fatty meats. Limit saturated fats by drinking skim or low-fat milk and using vegetable oils instead of butter whenever you can. Avoid hydrogenated oils, also called trans fats. These artificially made fats are found most often in processed foods, including many snack items. Trans fats, like saturated fats, have been shown to increase levels of bad cholesterol and eventually clog coronary arteries.

If you are overweight, your doctor may recommend that you try to lose weight. The reason: Excess weight puts an extra strain on the heart. Losing weight will also make you feel better and give you more energy. For advice on the healthiest way to lose weight, talk to your doctor.

Smoking poses a severe danger to the heart and lungs, especially for people suffering from conditions like pulmonary hypertension. If you smoke, the best thing you can do is quit. That's not easy, of course, but many people have successfully kicked the habit. Nicotine patches, gum, and other aids can make it easier. Support groups are available in many communities. You'll find useful resources at these Web sites:

http://surgeongeneral.gov/tobacco

http://www.lungusa.org/site/c.dvLUK9O0E/b.33484/k.438A/Quit_Smoking.htm

http://www.quitnet.com

For more information about quitting smoking, talk to your doctor.

Being exposed to secondhand smoke has been linked to a variety of health problems, including lung cancer and heart attacks. There is no direct evidence that secondhand smoke worsens symptoms of pulmonary hypertension. Still, experts agree that it's wise to avoid exposure as much as possible.

If you live with someone who smokes, ask them to quit. If they won't quit, ask that he or she smoke outside or in a separate space, such as the garage or back porch. Avoid places frequented by smokers. Choose non-smoking restaurants or the non-smoking sections. On days when air quality is poor, it's also a good idea to remain inside as much as possible.

People with pulmonary hypertension often worry that exercise could be dangerous. It's true that overly strenuous exercise can sometimes bring on the symptoms of PH, such as shortness of breath or dizziness. Exercise that involves lifting anything over 25 pounds can increase blood pressure in the pulmonary arteries, putting unwanted stress on the heart and lungs. Experts advise against heavy weight-lifting exercises for that reason.

At the same time, remaining as physically active as possible is essential to staying healthy when you have pulmonary hypertension.

The appropriate level of activity depends on you: your age, your overall health, and what you enjoy doing. Moderately strenuous activities such as walking are good for your heart and arteries and may have other health benefits, including relieving stress. Even people with advanced pulmonary hypertension are encouraged to walk, using portable oxygen. If walking is too tiring, you can stay invigorated with everyday activities. Even taking a spin in a wheelchair or on a motorized scooter is better than sitting or lying down. If you're not sure how active you should be, talk to your doctor.

Get plenty of rest and find opportunities to relax. Getting enough rest is the best way to deal with fatigue, which is a common complaint among people with pulmonary hypertension. Most adults need approximately eight hours of sleep each night: Sleep, like diet and exercise, is important for our bodies to function their best. Taking time out to relax will also help you deal with the inevitable stresses of dealing with a serious medical condition.

Stress, especially if it feels out of control, can be hard on your heart. People with pulmonary hypertension often say they feel better after doing simple relaxation exercises, such as closing their eyes and focusing on their breathing. A positive mental attitude can also help you feel better and may even keep you healthier. Of course, it is always important to plan time every day to do something you enjoy or to spend time with people you care for. For more tips on how to fight stress, click here.

Pregnancy can create a dangerous strain on the heart and lungs in women with pulmonary hypertension, endangering both mother and baby. Some of the medications used to treat pulmonary hypertension can also be harmful to the fetus. Doctors advise women of childbearing age with PH not to become pregnant.

Unfortunately, hormonal contraceptives, like birth control pills and patches, increase the risk of blood clots and thus also pose a risk for women with pulmonary hypertension. For that reason, doctors recommend using alternative forms of birth control. Many women with advanced pulmonary hypertension opt for sterilization because of the extreme risks to them if they become pregnant.

Because the air is thinner at high altitudes, the heart and lungs have to work harder to get enough oxygen. This can aggravate the symptoms of pulmonary hypertension. Over time, living at high altitudes has the potential to speed the progress of the disease. If you live in a city like Denver or another location at high altitude, your doctor may recommend that you consider moving to a lower elevation, if possible. Many patients with respiratory difficulties find that they breathe more easily and have more energy at low elevations.

Not everyone is affected the same way by residing at elevation, however. Many doctors recommend that patients with PH who live in areas of high elevation spend a week or two at sea level. If they notice that they have an easier time breathing or feel less fatigued, then it's worth considering a move.

Flying can pose a hazard for people with PH, because even in the pressurized cabins of planes the air contains less oxygen than air on the ground. People with advanced PH may need to travel with supplemental oxygen. Before getting on a plane, talk with your doctor. If he or she thinks you should travel with supplemental oxygen, your doctor will provide the airline with information about your medical condition and the need for oxygen.

The airline's medical team will also evaluate your medical record. Passengers are not allowed to use their own oxygen tanks and equipment. The airline will supply the appropriate equipment. Remember: Airlines have limited seats available for people who need in-flight oxygen. An airline can also refuse to fly passengers whom they deem unfit to travel for health reasons. Finally, make sure that you arrange to have oxygen cylinders and equipment available when you arrive at the airport. The airline is only responsible for providing the equipment on the flight. Oxygen distributors are found in most cities.

Physical exertion during the flight can increase the risk of worsening symptoms of pulmonary hypertension. Avoid drinking excess fluid before the flight in order to prevent trips to the lavatory. But remember to stretch your legs at your seat in order to prevent blood clots from forming in your legs.

Take good care of yourself. If you develop symptoms of respiratory tract infections, see your doctor immediately. Antibiotic therapy for lung infections is especially important for people with pulmonary hypertension. It's also important to get a pneumococcal pneumonia vaccine and yearly flu vaccinations to prevent these respiratory illnesses, which can be very serious in pulmonary hypertension patients.

-- Peter Jaret is a contributing editor for Health magazine and a winner of the American Medical Association's award for medical reporting. His work has appeared in National Geographic, Newsweek, Hippocrates, and many other national magazines. He is also the author of In Self-Defense (Harcourt Brace Jovanovich), Active Living Every Day, and Heart Healthy for Life.

References

First published October 29, 2003
Last updated November 4, 2008
Copyright © 2003 Consumer Health Interactive

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