Primary And Secondary Pulmonary Hypertension: How Do They Differ?

Dr. Skloven:
Often when I meet with patients they ask me what’s the difference between primary pulmonary hypertension and secondary pulmonary hypertension. Basically primary pulmonary hypertension is this disease with no underlying cause. It’s a disease in and of itself. It comes in two forms that we know of now, one is called familial and this is a disease that runs in families. And the second form is called idiopathic. Idiopathic is a medical term meaning we don’t know what the cause is, of unknown cause, and it occurs sporadically throughout the population, much more so in women than in men.

Secondary pulmonary hypertension is high blood pressure or high pressure in the pulmonary vessels due to some other underlying disease, the most common causes being emphysema, bronchitis, chronic obstructive pulmonary disease that people call COPD, disease of the heart, particularly heart valve disease – the valve between the left atrium and the left ventricle is called the mitral valve and if that valve leaks or if that valve doesn’t open normally it can cause, over time, increasing pressure in the lungs resulting in the same picture.

Other common causes of secondary pulmonary hypertension are a disease called pulmonary embolism and this is a disease caused by blood clots coming from some other place in the body, usually the legs, or often during pregnancy in the pelvis that come up through the vena cava, which is a vein that drains blood back from the legs and the abdomen and also from the upper body back into the heart, and these blood clots can travel up through this vein through the right side of the heart and get impacted in the lung vessels, and if this occurs repeatedly or if a large enough amount of blood clot occurs in the lungs it basically stops up the vessels and pressure begins to rise in order to get blood through the lungs.

There are a number of other forms of disease that are also more common in women called connective tissue diseases and I think we touched on this a bit earlier. The most common is systemic lupus, but there are other forms of this type of disease – rheumatoid arthritis is another common one that can cause pulmonary hypertension in the lungs.

About Dr. Z. David Skloven, M.D.:
Dr. Skloven is an Interventional Cardiologist at Banner Heart Hospital in Mesa, Ariz. After graduating from Cornell University with a Bachelor of Arts degree with Honors in Chemistry. Dr. Skloven attended medical school at the University of Maryland School of Medicine, graduating Cum Laude . He did both his internship and first year residency at Cornell University Hospitals in New York City. His second year residency was at the University of California in San Francisco. Dr. Skloven was a Cardiology Fellow under Dr. Eugene Braunwald from 1970 to 1972 in San Diego, California and then spent a year as Director of the La Jolla V.A. Hospital Cardiac Catheterization Lab.

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• High Blood Pressure