DEAR DR. DONOHUE: I am a woman, 81, recently diagnosed with pulmonary hypertension. What is it? What is the treatment? Is it curable? — A.F.
A: Hypertension is high blood pressure. “Pulmonary” refers to the lungs. Pulmonary hypertension, therefore, is high blood pressure in the lungs’ blood circulation, most often without high blood pressure in the rest of the body. The lungs are delicate structures. They can’t tolerate normal body blood pressure. The blood pressure in the lungs is only one-fifth of body blood pressure.
A rise in lung blood pressure can be secondary to chronic obstructive pulmonary disease — also known as COPD, a combination of emphysema and chronic bronchitis. Heart-valve problems can raise lung blood pressure. Illnesses like scleroderma and lupus can do it also. Or — and often this is the case — it happens without an identifiable cause and is then called idiopathic pulmonary hypertension.
“Cure” is too strong a word for this illness, but control is often possible. Extended-release nifedipine — a medicine also used to control ordinary high blood pressure — can bring down lung high blood pressure too. This medicine comes in many different brand names. Epoprostenol, a drug given by continuous intravenous infusion, lowers pulmonary hypertension. Three somewhat-new oral drugs — Tracleer, Letairis and Revatio — have markedly changed treatment of this illness. Revatio is a surprise. It’s the same medicine used for erectile dysfunction. By some quirk of fate, it has the property of lowering high lung blood pressure, and it’s been a godsend for patients with this problem.
DEAR DR. DONOHUE: If you have sugar diabetes and if regular sugar checks show your blood sugar stays at the right level, is it necessary to take medicines for it? — K.T.
A: It’s absolutely necessary to check with your doctor before stopping diabetes medicines.
If the doctor says you can experiment by stopping your medicines, it’s still necessary to continue checking your blood sugar to be sure it stays in the normal range without the help of medicine.
A person with the best chance of stopping diabetes medicines is one who has lost weight, carefully follows a prescribed diet and exercises daily.
Does that description fit you?
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
c. North America Syndicate
