Pulmonary hypertension, which is high blood pressure in the arteries of your lungs, occurs when the lung's tiny arteries narrow or become blocked. To maintain blood flow through these narrowed blood vessels, pressure increases in the arteries and puts stress on your heart. As the pressure builds, the heart's right ventricle must work harder to pump blood through the lungs. Pulmonary hypertension can occur by itself, but it is often caused by an existing disease. It is a rare condition that mostly affects women in their 30s or 40s.

The most common symptom is shortness of breath when you exercise, progressing to shortness of breath while at rest. Other symptoms are:

• Getting tired easily
• Fainting or dizziness
• Cough
• Chest pain
• Swelling in your legs
• Blue lips or skin

Often there is no known cause. This is called idiopathic pulmonary hypertension (formerly known as primary pulmonary hypertension). In other cases, called familial pulmonary hypertension, the cause is another medical condition. Conditions that can lead to pulmonary hypertension include the following:

• Heart disease
• Mitral stenosis or regurgitation
• Certain kinds of lung disease
• Obesity, especially with sleep apnea
• Chronic obstructive pulmonary disease (COPD)
• High altitude
• Left-side heart failure

Your health care provider will give you a thorough examination and order laboratory tests to diagnose your condition. You may have an x-ray or electrocardiogram (ECG). Other tests may include an echocardiogram, heart catheterization, lung scan, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) scan.

If your pulmonary hypertension is the result of an underlying disease, that disease must be treated. You must avoid excessive physical stress or exercise. If your disease has progressed, your doctor may recommend you have a lung or heart lung transplantation.

Drug Therapies

Some treatments your health care provider may use include the following:

• Supplemental oxygen
• Vasodilator therapy for those with no underlying disease
• Anticoagulant therapy if the primary problem is thromboembolic pulmonary disease
• Diuretics for right ventricular failure

Complementary and Alternative Therapies

If you have pulmonary hypertension, you should be under the care of a physician. Complementary and alternative therapies can be used with medical treatment, but only under your doctor's supervision.

Nutrition

While none of these supplements specifically treats pulmonary hypertension, they can promote heart health and function:

• Coenzyme Q10 (200 - 600 mg per day) supports cardiac function, is an antioxidant, and may help lower blood pressure. Do not take coenzyme Q10 if you take blood-thinning medication.
• L-carnitine (500 mg three times per day) improves endurance and is needed for efficient cardiac function. Do not take L-carnitine if you take blood-thinning medication or thyroid hormone.
• Magnesium aspartate (200 mg two to three times per day) increases efficiency of cardiac muscle and may help lower blood pressure. Magnesium interacts with many medications as well as other herbs and supplements, so talk to your doctor before taking magnesium.
• Potassium (20 mg per day) improves the ability of the heart muscle to contract. If you take a certain kind of diuretic, your doctor may recommend you also take a potassium supplement. The dose will depend on the level of potassium in your blood, so your doctor will determine the proper amount.
• Vitamin E (400 IU per day) and vitamin C (250 - 500 mg two times per day) are antioxidants that protect the heart and strengthen the immune system.
• Taurine (1,000 mg twice a day) enhances cardiac function and may help lower blood pressure.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Take these herbs only under your doctor's supervision. Many interact with each other and with other prescription medications, and can cause side effects. For cardiac support:

• Hawthorn (Crataegus monogyna), 240 - 600 mg per day.
• Motherwort (Leonurus cardiaca), 2 g or 1 cup tea two or three times per day. To make tea, steep 2 g in one cup boiling water. Strain and cool.
• Linden (Tilia cordata), 1 - 2 cups tea per day. May help lower blood pressure. To make tea, steep 2 g in one cup boiling water. Strain and cool.
• Asian ginseng (Panax ginseng), 200 - 600 mg per day.
• Garlic (Allium sativum), 600 - 900 mg per day. May help lower blood pressure.
• Rosemary (Rosmarinus officinalis), 1 cup tea three times per day; may help lower blood pressure. To make tea, steep 1 - 2 g of rosemary leaves in one cup boiling water. Strain and cool.
• White horehound (Marrubium vulgare) dilates blood vessels and may help lower blood pressure. Drink one cup of tea three times per day. To make tea, steep 1 - 2 g dried herb in one cup boiling water. Strain and cool.
• Danshen (Salvia miltiorrhiza ) also dilates blood vessels. Dosage varies and should be determined by your doctor.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Castor oil pack. Apply oil to a clean, soft cloth, place on chest and cover with plastic wrap. Place a heat source over the pack and let sit for 30 - 60 minutes. Use for 3 consecutive days, take 1 - 2 days off, and then repeat 3-day cycle.

Contrast hydrotherapy. Alternate hot and cold applications to the chest. Alternate 3 minutes hot with 1 minute cold. Repeat three times to complete one set. Do two to three sets per day.

Steams. Using three to six drops of essential oils in a humidifier, vaporizer, atomizer, or warm bath will stimulate respiration and circulation. Consider eucalyptus, rosemary, thyme, or lavender.

Acupuncture

May support treatment of symptoms by increasing circulation.

The prognosis for pulmonary hypertension is generally poor.

For the most part, women who have primary pulmonary hypertension should not get pregnant because the condition is dangerous for both mother and baby.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:195, 270, 276, 376.

Batyraliev LI, Makhmutkhodzhaev SA, Ecinci E, Pataria SA, Pershukov IV, Sidorenko BA, Preobrazhenski DV. Pulmonary hypertension and right ventricular failure. Part VI. Classification and pathomorphology of primary pulmonary arterial hypertension. Kardiologiia. 2007;47(1):75-81.

Bordow RA, Moser KM. Manual of Clinical Problems in Pulmonary Medicine. 4th ed. Boston, Mass: Little, Brown; 1996:304-311, 353, 424, 431-434.

Coulden R. State-of-the-art imaging techniques in chronic thromboembolic pulmonary hypertension. Proc Am Thorac Soc. 2006;3(7):577-83.

El Bardai S, Morel N, Wibo M, et al. The vasorelaxant activity of marrubenol and marrubiin from Marrubium vulgare. Planta Med. 2003;69(1):75-77.

Fauci AS, Braunwald E, Isselbacher KJ, et al., eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:1466-1468.

Fishman AP, Elias JA, Fishman JA, et al. Fishman's Pulmonary Diseases and Disorders. 3rd ed. New York, NY: McGraw-Hill; l998:1261-1296.

Gaine SP, Orens JB. Lung transplantation for pulmonary hypertension. Semin Respir Crit Care Med. 2001;22(5):533-40.

Hinshaw HC, Murray JF. Disease of the Chest. 4th ed. Philadelphia, Pa: WB Saunders Co; 1980:684-697.

Kassab R, Hamdan R, El AB, Azar R, Salame E. Beneficial effect of sildenafil following surgery for mitral stenosis complicated by pre-capillary pulmonary hypertension: report of two cases. Ann Cardiol Angeiol. 2006;55(5):286-90.

Mashour NH, Lin GI, Frishman WH. Herbal medicine for the treatment of cardiovascular disease: clinical considerations. Arch Intern Med. 1998;158(20):2225-2234.

Said SI. Mediators and modulators of pulmonary arterial hypertension. Am J Physiol Lung Cell Mol Physiol. 2006;291(4):L547-58.

Woodley M, Whelan A. Washington Manual of Therapeutics. 27th ed. Boston, Mass: Little, Brown; 1992:211-212.

Zagolin BM, Wainstein GE, Uriarte GP. Update in the diagnosis and therapy for pulmonary arterial hypertension. Rev Med Chil. 2006;134(7):902-9.

Zapfe jun G. Clinical efficacy of crataegus extract WS 1442 in congestive heart failure NYHA class II. Phytomedicine. 2001;8:262-6.