I have severe emphysema and have recently been diagnosed with pulmonary hypertension. I have been told not to take beta blockers and was wondering if there is anything else I can take?
Thank you for any options you can give me.
—How to Treat Hypertension
Dear How to Treat,
If the pulmonary hypertension is secondary to the emphysema, then oxygen levels need to be monitored. Oftentimes pulmonary hypertension in this setting is related to low levels of oxygen and potentially responsive to oxygen therapy.
When pressure in the pulmonary circulation becomes abnormally elevated, it is referred to as pulmonary hypertension, pulmonary artery hypertension, or PAH.
Pulmonary hypertension results from constriction, or stiffening, of the pulmonary arteries that supply blood to the lungs. Consequently, it becomes more difficult for the heart to pump blood forward through the lungs. This stress on the heart leads to enlargement of the right heart and eventually fluid can build up in the liver and other tissues, such as the in the legs.
The good news is there are numerous medications now available for treating pulmonary hypertension, but they work best in treating so-called primary pulmonary hypertension rather than secondary pulmonary hypertension as we see with COPD. We sometimes do try these pulmonary hypertension medications in it in COPD and sometimes they can be effective, but one needs to be extremely careful since these drugs can worsen oxygenation in some folks with COPD.
Beta blockers are not part of therapy for pulmonary hypertension. For years we did not think they could be safely used in patients with COPD since they cannot be used in asthma. More recently, data suggests that beta blockers can generally be used safely in COPD patients but with extra care and caution.
Thanks for writing,
The COPD Doctor
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