Pathophysiology and Therapeutic Approaches to Acute Decompensated Heart Failure



acute pulmonary congestion :: Article Creator

Can High Blood Pressure Make You Breathless?

Shortness of breath, medically known as dyspnoea, is a worrying symptom arising from many underlying health problems. While hypertension is often linked to lung or heart problems, the relationship between high blood pressure and dyspnoea requires careful consideration.

We spoke to our expert Dr Lakshmi Navya, Consultant- Cardiology, Manipal Hospital, Vijayawada, who explained this connection and how it unfolds in the body.

Does High Blood Pressure Cause Shortness of Breath?

high-blood-pressure

Hypertension is not a direct cause of breathlessness. However, it dramatically raises the chances of having conditions that cause dyspnoea. Chronic, poorly controlled hypertension can lead to Left Ventricular Hypertrophy (LVH), which is a thickening of the left ventricle of the heart. "This thickening makes it more difficult for the heart to relax and fill with blood, a condition known as diastolic dysfunction. This dysfunction can cause pulmonary congestion, which is characterised by shortness of breath, particularly with exertion or when lying down," explained Dr Navya.

The Role of Coronary Artery Disease (CAD)

Moreover, hypertension is also a predisposing factor to Coronary Artery Disease (CAD). CAD can manifest with dyspnoea, either due to angina or myocardial infarction. 

A 2022 study highlighted that hypertension is a prevalent risk factor for CAD, as it can facilitate the development of coronary atherosclerosis and result in the narrowing of the coronary lumen. These two conditions frequently coexist due to overlapping risk factors, shared physiological mechanisms, and intricate interactions. Patients who have both CAD and HTN tend to experience poorer outcomes and prognosis compared to those with only one of the conditions.

Also Read: Oxygen Deficiency: How To Know If Your Body Is Low On Oxygen

Hypertensive Crisis and Pulmonary Oedema

pulmonary-oedema

"Acute pulmonary oedema (APO) can also be caused by a severe and acute rise in blood pressure, known as a hypertensive crisis. It is a potentially life-threatening situation in which fluid accumulates in the lungs, leading to severe respiratory distress," added Dr Navya.

According to the Royal Australian College of General Practitioners (RACGP), the main treatments for APO include administering oxygen, positioning the patient in an upright position, using glyceryl trinitrate, applying positive airway pressure, administering frusemide, providing morphine, and utilising inotropic agents.

Other Possible Causes of Breathlessness

It is essential to differentiate dyspnoea due to complications of hypertension from other possible etiologies, including Chronic Obstructive Pulmonary Disease (COPD), asthma, or pulmonary embolism. A complete clinical assessment can be performed for diagnosis. The evaluation comprises careful medical history, physical examination, and appropriate diagnostic tests.

Also Read: Can Acid Reflux Lead To Breathlessness? Read On To Know

Diagnostic Tools to Identify the Cause

To determine the exact cause of dyspnoea, doctors may use a combination of diagnostic tools, including:

ECG

  • Electrocardiogram (ECG): To measure heart rhythm and identify indicators of LVH
  • Echocardiogram: To assess cardiac structure and pumping efficiency
  • Chest X-ray: To search for abnormality in the lungs or fluid accumulation
  • Pulmonary function tests: To assess lung capacity and airflow
  • Blood tests: To evaluate kidney function and search for other possible red flags
    • Bottomline

    Dr Navya concluded. "Hypertension does not directly cause dyspnoea; however, it can lead to long-term effects on the heart and arteries, significantly increasing the risk of other conditions that do. Therefore, the appropriate treatment of hypertension is essential not only to prevent cardiovascular events but also to reduce the risk for dyspnoea secondary to these issues. A thorough clinical examination is crucial in determining the aetiology of dyspnoea in hypertensive individuals and is central to the personalisation of treatment approaches."

    [Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]





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