Systemic and Pulmonary Hypertension

Overview

Hypertension, or high blood pressure, is a condition where the force of blood against the artery walls remains consistently elevated. There are two main types:

• Systemic Hypertension: High blood pressure that affects the arteries throughout the body.
• Pulmonary Hypertension: High blood pressure specifically in the arteries that carry blood from the heart to the lungs.

Both forms place added strain on the heart and blood vessels. Over time, uncontrolled hypertension can lead to heart failure, stroke, kidney disease, or other serious complications. At Cardiology Care NYC, we provide comprehensive evaluation and individualized management to keep blood pressure under control and protect long-term heart health.

Causes

Systemic Hypertension

Systemic hypertension often develops gradually and is influenced by lifestyle and genetic factors. Common causes and risk factors include:

• High sodium intake
• Obesity or being overweight
• Sedentary lifestyle
• Smoking and excessive alcohol consumption
• Chronic stress
• Family history of hypertension
• Medical conditions such as diabetes, kidney disease, or thyroid disorders

Pulmonary Hypertension

Pulmonary hypertension occurs when the small arteries in the lungs become narrowed or stiff, making it harder for blood to flow through. This increases pressure in the pulmonary arteries and puts stress on the right side of the heart. Causes include:

• Chronic lung diseases (e.g., COPD, interstitial lung disease)
• Left heart conditions (e.g., heart failure, mitral valve disease)
• Blood clots in the lungs (pulmonary embolism)
• Sleep apnea
• Autoimmune disorders (e.g., lupus, scleroderma)
• Genetic predisposition

Identifying the underlying cause is essential for proper treatment and long-term management.

Symptoms

Systemic Hypertension

Often called the “silent killer,” systemic hypertension may not cause noticeable symptoms until it becomes severe. When present, symptoms can include:

• Headaches (especially in the morning)
• Dizziness
• Blurred vision
• Shortness of breath
• Chest discomfort
• Nosebleeds (in rare cases)

Pulmonary Hypertension

Pulmonary hypertension symptoms tend to appear gradually and may worsen over time. They include:

• Shortness of breath during activity (and eventually at rest)
• Fatigue or weakness
• Chest pain or pressure
• Dizziness or fainting (especially during exertion)
• Swelling in the ankles, legs, or abdomen
• Bluish tint to lips or skin (cyanosis)

If you experience these symptoms, it’s important to seek evaluation promptly to prevent heart strain or failure.

Diagnosis

At Cardiology Care NYC, we use advanced diagnostic tools to determine the type and severity of hypertension, as well as any underlying causes. Diagnostic evaluations may include:

• Blood pressure monitoring: Regular in-office and home measurements to assess consistency and severity.
• Electrocardiogram (ECG/EKG): Detects heart rhythm abnormalities or strain caused by high blood pressure.
• Echocardiogram: Evaluates heart structure and function, including how well the heart pumps blood.
• Chest X-ray: Assesses the size and shape of the heart and lungs, useful in pulmonary hypertension cases.
• Cardiac ultrasound or doppler ultrasound: Visualizes blood flow and pressure in the heart and pulmonary arteries.
• CT or MRI: Provides detailed images of the heart and pulmonary vessels.
• Blood tests: Identify underlying conditions such as kidney disease, thyroid dysfunction, or autoimmune disorders.

Comprehensive evaluation helps tailor treatment to each patient’s unique condition.

Treatment

Our approach to hypertension management focuses on non-surgical, personalized care controlling blood pressure, reducing symptoms, and improving quality of life.

Lifestyle Modifications

A heart-healthy lifestyle is a cornerstone of treatment for both systemic and pulmonary hypertension:

• Follow a low-sodium, balanced diet (e.g., DASH or Mediterranean-style diet)
• Maintain a healthy weight
• Engage in regular, moderate physical activity as recommended by your cardiologist
• Limit alcohol intake and quit smoking
• Manage stress with mindfulness, deep breathing, or relaxation techniques
• Get adequate sleep and address conditions like sleep apnea

Medications

Depending on the type and severity of hypertension, medication may be prescribed to:

• Lower systemic blood pressure (ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, or diuretics)
• Improve blood flow in pulmonary hypertension (vasodilators, endothelin receptor antagonists, phosphodiesterase inhibitors)
• Manage underlying conditions contributing to elevated pressures (heart failure, lung disease, etc.)

Your cardiologist will design a safe, effective treatment plan and adjust medications as needed for optimal results.

Ongoing Monitoring

Long-term success in managing hypertension depends on consistent follow-up and evaluation.

At Cardiology Care NYC, we emphasize:

• Routine blood pressure tracking and follow-ups
• Echocardiograms and lab tests to monitor progress
• Medication reviews to ensure effective dosing and minimize side effects
• Ongoing lifestyle coaching for sustainable heart health

Our goal is to prevent complications, enhance well-being, and empower patients to take charge of their cardiovascular health.

When to See a Doctor

Schedule a consultation if you:

• Have persistently high blood pressure readings
• Experience shortness of breath, dizziness, or unexplained fatigue
• Have swelling in the legs or chest discomfort
• Have risk factors such as diabetes, high cholesterol, or a family history of heart disease

Early detection and consistent management can make a significant difference in outcomes for both systemic and pulmonary hypertension.