What is pulmonary hypertension?

Pulmonary hypertension, sometimes called PH, is high blood pressure in the blood vessels in the lungs. This is different from what we usually think of as “high blood pressure,” which measures blood pressure in the arteries that carry blood from the heart to the body.

People with PH have narrower blood vessels in their lungs, making it harder for blood to move through the lungs as you inhale and exhale. While there is no cure for pulmonary hypertension, there are several medications that can slow the disease, allowing you to live your life more easily.

UW Health is home to one of just four centers in Wisconsin (and the only one outside of greater Milwaukee) accredited by the Pulmonary Hypertension Association. Accredited PH centers treat a higher volume of patients and are more familiar with potential signs of the disease. They also offer the widest array of treatment options.

Symptoms and diagnosis

Know what to look for

Pulmonary hypertension is often misunderstood and can be tricky to diagnose because many of its symptoms, such as shortness of breath, can be mistaken for something else such as asthma, heart failure or chronic obstructive pulmonary disease (COPD).

Some of the more common symptoms include:

  • Shortness of breath

  • Feeling unusually tired

  • Chest fullness or pain

  • Fainting, dizziness or light-headedness

  • Swelling in the ankles, legs or belly

PH can also be associated with another underlying condition, such as congenital heart disease, COPD, sleep apnea, liver disease or lupus.

Moreover, pulmonary hypertension tends to come on gradually. For example, you may have mowed your lawn without a problem last year but now find yourself having to take breaks to catch your breath.

Common tests for pulmonary hypertension

During your visit with an expert PH provider, we will discuss your personal health history, family history and symptoms. Based on what we learn, you may have one or more of the following tests to help determine whether you have PH and, if so, what type.

This test uses ultrasound to estimate the blood pressures in your lungs. If one side is working harder than the other, it could be a sign of PH.
This is a breathing test that tells us how well your lungs are working.
This tells us how much exercise you can tolerate
Through a standard blood draw, we can determine whether something other than pulmonary hypertension might be causing your symptoms.
If the above tests suggest that you may have pulmonary hypertension, we will schedule a right-heart catheterization, often called the “gold standard” test for PH. This test, typically performed with light sedation, involves the placement of a thin tube (catheter) that travels through blood vessels to your heart. The catheter can often be placed through a vein or artery in your arm. It provides the most precise measure of the blood pressures in the lungs as well as those in the right and left sides of the heart.

What type of PH do I have?

There are five distinct groups of pulmonary hypertension based on different causes.

Pulmonary arterial hypertension is the rarest form of PH. It occurs when the arteries in the lungs become narrowed, thickened or stiff, forcing the right side of the heart to work harder than it should. Women are more likely to be diagnosed with this type of PH, which can cause the heart to lose its ability to pump enough blood through the lungs to meet the needs of the whole body.
This is the most common form of PH. These patients have arteries and lungs that are not as thick or stiff as those in Group 1, but have problems with how the heart squeezes or relaxes, or have problems with the valves on the left side of the heart. Accordingly, the left heart cannot keep up with the blood returning from the lungs, causing a “backup” of blood which raises pressure in the lungs.
For these patients, PH is caused by lung diseases such as COPD, emphysema, interstitial lung disease or pulmonary fibrosis; or from sleep apnea or from living in an area of high altitude for a long time. Accordingly, the arteries in the lungs tighten so that blood can only go to areas of the lungs that are receiving the most air and oxygen. This tightening leads to high blood pressure throughout the lungs.
These patients have a form of PH called chronic thromboembolic pulmonary hypertension (CTEPH), which can occur when the body is not able to dissolve a blood clot in the lungs. Accordingly, normal blood flow is blocked, forcing the right side of the heart to work harder.
Patients in this group have PH that is secondary to other diseases in ways that are not well understood. Examples of these associated conditions include sarcoidosis, sickle cell anemia, chronic hemolytic anemia, splenectomy (spleen removal) and certain metabolic disorders.


How we can help

While there is no cure for pulmonary hypertension, several medications are available to ease your symptoms, improve your quality of life and keep the disease from worsening.

Depending on what type of PH you have, medication(s) will be prescribed to achieve one or more of the following:

  • Relax the blood vessels

  • Increase the blood flow

  • Reduce the risk for blood clots

  • Remove excess fluid from the body

If medications do not control the symptoms, patients may be treated with surgery or be listed for a lung transplant or heart-lung transplant.

Meet our team

Experts dedicated to you

To provide you with the greatest expertise, our team includes a pulmonologist, a cardiologist and a nurse practitioner who specializes in caring for patients with pulmonary hypertension. Our patients also work closely with our nurse navigator and have access to a social worker.

Our providers


Your home for top-notch care

The pulmonary hypertension clinic is located at University Hospital in Madison.