Pulmonary hypertension patients can benefit from exercise training: Study

A new study shows that exercise training as a treatment is a safe way to improve the quality of life for people who suffer from pulmonary hypertension. Pulmonary hypertension affects roughly 10 to 15 out of every million Americans and has an annual mortality rate of 15 percent.

The condition occurs as a result of high blood pressure which affects the heart and the lungs, often making the patient dizzy or tired and can make it more difficult to breathe. It can even lead to heart failure if it is left untreated.

The study was performed by cardiologists as UT Southwestern Medical Center. In the past, medical professionals were hesitant about prescribing exercise to pulmonary hypertension patients because they were worried about adding extra strain on the heart. The senior author of the study Dr. Jarett Berry, associate professor of Internal Medicine and Clinical Sciences and Dedman Family Scholar in Clinical Care at UT Southwestern, said, “Our analysis found those concerns may be misplaced. More importantly, exercise had a positive effect on several measures of heart function as well as overall quality of life.”

The study involved more than 400 people with chronic pulmonary hypertension. The participants went through a series of supervised exercise training sessions, so the researchers could discover what level of exercise was safest. They found that lower levels of intensity were more successful than the level of exercise that is normally suggested for patients with heart failure and pulmonary issues.

The study does not suggest that all pulmonary hypertension patients should start exercise training. Anyone with a heart conditions should talk to a doctor before jumping on a bike, going for a run or even practicing yoga. The first author of the study Dr. Ambarish Pandey, a cardiology fellow at UT Southwestern Medical Center, said, “It is important for patients with pulmonary hypertension to consult their doctor before starting any exercise regimen, particularly for pulmonary hypertension patients.”

The study was published in Circulation: Heart Failure.

Symptoms and causes of pulmonary hypertension

As mentioned above, pulmonary hypertension (PH) is a type of high blood pressure. It affects lung arteries and your heart. It is caused by the narrowing, blocking or destruction of capillaries and pulmonary arteries which make blood flow through the lungs more difficult and raise the pressure in the lungs’ arteries. Due to an increase in pressure, the right ventricle of the heart that pumps blood through the lungs is forced to work harder and becomes weaker overtime. It can even cause the heart muscle to fail.

When there is no cause for a person’s pulmonary hypertension it is called idiopathic pulmonary hypertension. However, if a person has secondary pulmonary hypertension there can be a variety of causes, including:

• Blood clots in the lungs
• Chronic obstructive pulmonary diseases (such as emphysema)
• Sleep apnea (and other related disorders)
• Cirrhosis
• AIDS
• Sick cell anemia
• Lupus, scleroderma and other connective tissues disorders
• Pulmonary fibrosis and other lung diseases
• Heart failure on the left-side
• High altitudes of more than 8,000 feet, this includes living at high altitudes and climbing/hiking
• Stimulants, such as cocaine
• Eisenmenger syndrome, a type of congenital heart defect

There are many symptoms of pulmonary hypertension, some of which include:

• Fatigue
• Chest pain or pressure
• Shortness of breath (begins during exercise, but will eventually happen during rest also)
• An increase in heartbeat or palpitations, often feels like it’s racing
• Dizziness, feeling light-headed and even fainting
• Lips and skin can appear blue
• Ankles and legs swell, and later swelling can also occur in abdomen
• Decrease in appetite

If you have pulmonary hypertension, but still want to exercise, there are tips to keep in mind.

Safe exercise tips for pulmonary hypertension patients

Moderate or gentle exercise, on a regular basis, is beneficial for all of us, including people suffering from pulmonary hypertension. However, before you start your fitness routine, make sure you speak with your doctor, especially if you have just been diagnosed with PH. If you are all set to get started, here are a few safe exercise tips for pulmonary hypertension patients:

• Talk with your doctor first – as mentioned above, before beginning any exercise plan, be sure to speak with your healthcare professional to find out what you can and cannot do.
• Start slow – especially if you haven’t not practiced regular fitness in the past. If you don’t feel well at any point, especially due to pain, stop exercising immediately.
• Don’t push yourself too hard – be sure you aren’t being impatient. Don’t progress to the point of shortness of breath, dizziness or chest pain.
• Take a buddy – when you start your exercise treatment, have someone with you in case of negative effects.
• Stay inside – if the temperature is too cold or too hot it can cause overreactions to exercise, so avoid outdoor fitness.
• Stick with safe activities – work your upper and lower body at different times and be sure to follow any special rules set out by your doctor.
• Check your pulse – try to keep your pulse in the 90s for optimum results.

Keep in mind that any exercise is better than nothing.  Start slowly with simple exercise like a morning stroll around the local mall and work your way to gentle weight training. Keep your plan as basic as possible and incorporate exercise into your daily routine. Aside from exercise, there are other ways to help treat pulmonary hypertension.

Additional ways to treat pulmonary hypertension 

If you have had few results from regular exercise, have been told to avoid fitness by your doctor or just want additional methods for relieving your PH, there are a few lifestyle changes that could be beneficial.  Here are additional ways to treat pulmonary hypertension, aside from exercise:

• Rest up – getting plenty of sleep and regular rest can help reduce fatigue associated with PH.
• Avoid smoking – your heart and lungs will thank you. If you’re having difficulty, get help from your doctor or friends and family. Also avoid secondhand smoke.
• Reduce stress – exercise routines that involved yoga and meditation can be helpful, or even something as basic as taking a bath, reading a book or listening to soothing music.
• Avoid high altitudes – as high altitudes can worsen symptoms of PH, avoid traveling to or living at higher altitudes (above 8,000 feet).
• Prevent low blood pressure – lowering blood pressure can cause fainting spells or even death for people with PH. Avoid saunas, hot tubs or long baths and showers with hot water.
• Avoid pregnancy and birth control pills – birth control pills can increase the chance of blood clots, speak with your doctor for alternatives. For those with PH, pregnancy can be life-threatening for the mother and baby.
• Eat healthy and maintain weight – try limiting your salt intake an avoiding processed foods.

If you are hoping to change your eating habits to help maintain a healthy weight and treat pulmonary hypertension, there are certain foods which should be enjoyed or avoided.

Diet Tips for Pulmonary Hypertension Patients

Help gain control of your pulmonary hypertension by choosing the right foods and sticking with a routine. Here are a few diet tips for PH patients.

• Reduce your sodium intake. Choose fresh ingredients and avoid adding salt to your food before tasting it.
• Avoid fluids. To prevent fluid buildup and weight gain, avoid consuming too many liquids.
• Eat more iron. Pulmonary hypertension can become aggravated from low iron levels. Be sure to ingest iron-rich foods with vitamin C to ensure they are being properly absorbed.
• Stay away from coffee. Avoid stimulants, such as coffee and tea, to regulate your blood pressure and help you sleep better.
• Eat more garlic. Raw or fresh garlic can help keep blood pressure at a healthy level.
• Watch vitamin K intake. Too much can change the thickness of your blood and affect your blood-thinner medications.

To help keep track of your diet and the side effects experienced after eating, be sure to keep a food journal. It will help you better understand your body and learn how to effectively treat the pulmonary hypertension.

Developing pulmonary hypertension means that you will have to make changes to your fitness routine, diet and everyday life. However, these simple changes can help you feel better and even boost your energy. Creating a new schedule that incorporates the healthy changes can help you better treat the condition. Remember to speak with your doctor before making any decisions.