Pulmonary Hypertension more than simply high blood pressure

Pulmonary Hypertension (PH) is emerging as a serious health threat across South Africa, particularly in underserved communities where access to healthcare remains limited. Globally, PH affects around 1% of the population [1], which equates to approximately 80 million people. It has been estimated that PH is likely to be more prevalent in the developing world (including South Africa) because of the higher presence of risk factors such as schistosoma, HIV, and viral hepatitis. Also, in the developing world, cost factors tend to limit access to early diagnosis and treatment. [2]

Pulmonary Hypertension is often misunderstood. It is more than simply high blood pressure, explained Vanessa Snow, Head of Medical Affairs at Johnson & Johnson Innovative Medicine South Africa. “It is a condition that sees arterial pressure impact the respiratory system – in other words, the lungs – and frequently, the right-hand side of the heart,” she said. “Blood vessels in the lungs become narrowed, blocked, or even destroyed. This slows blood flow, increases pressure in the lungs, and eventually causes the heart muscle to weaken and fail.” [1]

Symptoms of PH can be misleading, often leading to misdiagnosis. [3] Early signs include shortness of breath, dizziness, and fatigue, which are frequently confused with asthma. [4] “When typical asthma treatments fail to relieve these symptoms, further investigation often reveals PH,” said Snow. Other symptoms may include shortness of breath, a blue or grey tinge to the skin depending on skin tone, chest pressure or pain, swelling in the legs, ankles, and abdomen, and fatigue. [5]

PH is typically diagnosed between the ages of thirty and sixty. As people grow older, lifestyle factors such as obesity, smoking, living at high altitudes, and exposure to asbestos further increase the risk. Other causes include the use of certain medications such as some weight loss remedies, illegal drugs like cocaine and methamphetamine, congenital heart defects, and certain chronic diseases. [5]

Snow said that although there is currently no cure, effective treatments are available to manage the disease, improve symptoms, and extend life expectancy. She stressed that early diagnosis is key. “Aside from medication, the most powerful tools we have against diseases like PH are education and awareness,” she said. “As people age, it becomes increasingly important to test for PH during annual health checkups. Early intervention leads to better management outcomes.” A multidisciplinary approach to PH care, including emotional support, is essential to ensure that patients receive comprehensive care [6], from initial symptom management to advanced therapies aimed at treating underlying causes.

Organisations such as the Pulmonary Hypertension Association of South Africa are helping to bridge the gap. [7] Describing themselves as “a source of support, connection and hope,” the association offers patients and families a lifeline of information, support groups, and advocacy.

Snow added that, “As constantly refined medical interventions show greater efficacy and become more affordable, patients in South Africa will increasingly be able to reap those benefits.”

PH remains a critical but often overlooked public health issue in South Africa. With greater awareness, earlier diagnosis, and expanded treatment options, there is hope that more patients will enjoy longer and better-quality lives.