Reviewed By: Pramod Kerkar, MD, FFARCSI

Tobacco can cause chronic lung diseases that are characterized by hypoxemia (this means a lower level of oxygen in the blood) such as emphysema and chronic obstructive pulmonary disease.

Can Pulmonary Hypertension Be Caused By Smoking?

Can Pulmonary Hypertension Be Caused By Smoking?

Tobacco in some way can cause pulmonary hypertension. The initial lesion begins in the vascular endothelium and then follows a process of pulmonary vascular proliferation, which causes long-term pulmonary hypertension. In the presence of pulmonary hypertension (PH) associated with respiratory diseases and / or hypoxemia -group 3 of the clinical classification of PH-, it is mandatory that the patient interrupt the smoking habit in a clear manner. In other forms of PH tobacco is contraindicated, but unfortunately there are patients diagnosed with this condition who continue to smoke.

Pulmonary hypertension (PH), common in many diseases, especially those that affect the heart and lung, can manifest in different clinical processes. There is, for example, pulmonary arterial hypertension, considered a rare form of PH. Rare as there are only 15 cases per million inhabitants. Within pulmonary arterial hypertension we find different forms: idiopathic, rheumatism diseases, connective tissue diseases, by ingestion of anorectics (drugs to lose weight).

The cause of pulmonary hypertension is unknown in many patients, in these cases being called idiopathic pulmonary arterial hypertension. At least, there is a variant of pulmonary arterial hypertension, hereditary, of which it is known more things: the disease begins in the endothelium, which is injured by multiple causes: toxic, drugs, viruses, etc, but requires the individual predisposition of the patient and that is where science is progressing because it has been found genetic mutations in a significant percentage of patients who develop the disease. In fact, when there are at least two affected members of the same family, you can talk about hereditary PH; there it is found a mutation called BMPR2 and, in some way, it can be studied the rest of the non-affected family members to see if they are carriers and be able to give them genetic counseling.

From Mild/Moderate to Severe Pulmonary Hypertension:

Of the other types of pulmonary hypertension, the most common is left heart disease. They are patients in whom, due to coronary disease, hypertension or valvular disease, the left side of the heart fails, which becomes dysfunctional and the lung reacts by increasing pulmonary pressure. This pulmonary hypertension, in general, is of a mild-moderate degree and does not require any specific treatment, but the cause that origins it must be treated: if a patient has a severe mitral stenosis, they will have to be operated on and the PH will disappear.

Chronic pneumopathies, which are chronic respiratory diseases that occur with lack of oxygen, also generate mild to moderate pulmonary hypertension. The really severe PH associated with these pneumopathies is very scarce: 5% of the patients. For them, the treatment is based on oxygen therapy and trying to improve oxygenation with bronchodilator drugs.

One of the symptoms of pulmonary hypertension is dyspnea (difficult breathing). This is when we wonder if for these patients, the practice of sports is contraindicated, or is it advisable as long as it is carried out under strict medical supervision. According to experts on the subject, dyspnea is the cardinal symptom of this disease. In all forms of pulmonary hypertension the patient begins to develop respiratory distress, first in great efforts and then progressively. What happens is that the right ventricle is overloaded, that is, it increases the vascular-pulmonary resistance and the right ventricle dilates and loses contractile force because it cannot push the blood towards the lung to be oxygenated and that is, of some form, which produces a lack of air, which in the end is heart failure.

Conclusion

Tobacco is a public health problem and although its association with cardiovascular diseases, with chronic obstructive pulmonary disease and cancer is widely recognized, in recent years there is increasing evidence of its association with another group of pathologies, including diffuse pulmonary diseases related to tobacco. Smoking is a recognized risk factor for the development and progression of this group of diseases.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: January 10, 2019

This article does not provide medical advice. See disclaimer

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