Primary Pulmonary Hypertension May Be More Easily Detected

Cleveland, OHPatients with Primary Pulmonary Hypertension (PPH) may have a new reason for hope after a recently published study showed that PPH might be easier to detect than was previously thought. Unfortunately, the findings might be too late for patients who developed PPH after taking the diet drug combination fen-phen.

According to a study published in the January 16 issue of Proceedings of the National Academy of Sciences, and reported in the Cleveland Plain Dealer, a doctor at the Cleveland Clinic found that hypertensive lung cells behave in a similar manner to cancer cells in that they grow quickly without oxygen and use large quantities of sugar. The doctor than put the hypertensive cells through a process that is used to detect cancer and the cells responded the same way that cancer cells do - they reacted to a liquid ingested by the patient and lit up when scanned.

The information from the study may make treatment of PPH patients easier because it can possibly be diagnosed more quickly. Generally, PPH is difficult to diagnose because it requires a number of tests and is also diagnosed by eliminating other problems. Most patients with PPH suffer from extreme fatigue after minor exertion, however they usually believe they are simply out of shape.

An ability to detect PPH may also lead to further understanding of the disease, which may eventually lead to a cure. For now, though, the findings indicate that detecting and diagnosing PPH may occur sooner after the onset of the disease than it has traditionally been.

PPH is a condition in which blood pressure in the pulmonary artery is abnormally high. The condition is fatal because the strain of pushing blood through the artery causes heart failure. The condition is called Primary Pulmonary Hypertension because there is no obvious cause of the high blood pressure. In other cases of Pulmonary Hypertension, known as Secondary Pulmonary Hypertension, there is an identifiable cause, such as a disease or a dysfunction.

In addition to the cause being unknown, researchers also do not know why PPH usually affects younger adults and usually women. PPH has been found to develop in people who took fen-phen in the late 90s, before it was removed from the market. People who took fen-phen for longer than three months were particularly susceptible to developing fen-phen.

Fen-phen was a combination of either Pondimin (fenfluramine) or Redux (dexfenfluramine) and phentermine. The drugs were popular because they suppressed people's appetites by increasing their serotonin levels, helping people to feel full and therefore lose weight.

However, as early as 1995 at an advisory committee meeting set up by the FDA to discuss the approval of Redux, critics noted that a release in the International Primary Pulmonary Hypertension Study (IPPHS) linked substances related to fenfluramine with PPH. Despite this knowledge, the FDA approved Redux for use in April 1996.

Symptoms of PPH include shortness of breath, dyspnea (breathing with difficulty), fatigue, dizziness, fainting, and chest pain. Effects of PPH include blood leakage from pulmonary vessels, a decrease in the blood's oxygen levels, an increase in red blood cells, and thickening of the blood. Treatment for PPH can be difficult, including heart catheters and oxygen with some patients eventually requiring lung and/or heart transplants. PPH may not develop for years after exposure to fen-phen, so anyone who took the diet drugs in the late 90s may still be at risk for developing PPH.

Other injuries caused by taking fen-phen include heart valve damage and endocardial fibrosis. Fen-phen was marketed by American Home Products, which is now known as Wyeth.