In the United States we have a lower threshold for treating hypertension, mild hypertension. The recommendations of our national governing bodies are that mild hypertension be treated non-pharmacologically, that is with lifestyle modifications, for three to six months and that the blood pressure be repeated numerous times to establish whether indeed the hypertension is fixed. Many patients will have blood pressures that come down into an acceptable level, a diastolic of less than 95 for example, with no cardiovascular risk factors, that is no diabetes or high cholesterol, history of premature coronary disease among your family members, that might be blood pressure that could be managed through lifestyle modifications alone. She seems to have shortness of breath walking up the stairs and a lot of fluid collecting in her legs. And I've never been able to get a good explanation of what the pulmonary part of the hypertension is.
Pulmonary hypertension has nothing to do with systemic hypertension.
There are two circuits to the circulation. One to the pulmonary circulation, the rest to everything else. Hypertension, as I'm involved with it, involves hypertension in the systemic circuit. Pulmonary hypertension sometimes results from underlying lung disease or sometimes primary disease of the pulmonary vessels. The swelling in the legs relates to high pressures in the right side of the heart that are then transmitted down through the liver and raising pressure in the legs.