Cold air and freezing winds can exacerbate symptoms of pulmonary hypertension (PH) and make breathing extra difficult for those living with the condition. It’s important to understand how and why cold weather affects PH, as well as what you can do to manage your symptoms in the colder months. By working with your health care provider, you can come up with a plan for keeping your symptoms under control and staying comfortable — even when it’s cold outside.
Some people diagnosed with PH find that the condition is even worse when it’s cold outside. Many myPHteam members have experienced this. “I live in Canada,” shared one member, “and now that winter has arrived, I have noticed it is really hard to take a deep breath or walk very far outside in the cold air.”
Another wrote, “This cold, cold weather isn’t helping. I have a much harder time breathing when I go outside.”
This issue is echoed throughout the myPHteam community. Member after member agrees: “I am really struggling with the cold weather,” wrote one member, while another shared, “It’s cold, and it affects my breathing.”
One member summed it up when they explained, “I don’t mind the cold, but my breathing does sometimes.”
It’s common to struggle with shortness of breath while moving around in the cold. This can make shoveling snow or cleaning out your gutters much more difficult. It can also mean that people end up spending a lot of time alone in the winter because leaving the house is a challenge.
Hypertension refers to high blood pressure. PH occurs when the blood pressure in the lungs rises beyond safe levels. People diagnosed with PH (or pulmonary arterial hypertension) typically have thick or narrowed blood vessels in the lungs or a narrowed pulmonary artery in the right side of the heart. This condition of vascular disease makes it hard for the lungs to get enough blood flow to oxygenate the blood.
This lack of oxygen in the blood leads to symptoms all over the body (systemic symptoms). Chest pain is one common symptom of PH, although PH can lead to other cardiovascular problems, such as blood clots and even heart failure. Additional health issues such as chronic obstructive pulmonary disease, scleroderma (a hardening of the skin), sleep apnea, and other conditions can increase risk factors when living with PH.
Cold weather can cause these blood vessels to constrict even more. Breathing in cold air may affect the blood vessels in the lungs, causing them to constrict (narrow). If these blood vessels become even narrower than they already are, breathing would become more difficult than usual.
High altitudes can worsen the effects of cold weather on those with PH. Because there are lower oxygen levels at higher altitudes, it is already harder to breathe. When you add cold temperatures to that, getting enough oxygen may feel impossible — leading to shortness of breath and lightheadedness.
People diagnosed with PH may also experience Reynaud’s phenomenon. Upon exposure to cold (or even cool) air, the blood vessels in their fingers and toes constrict. This causes the fingers and toes to turn red or purple at even the slightest hint of cold.
Fortunately, there are many ways that you can mitigate the effect that cold weather has on your PH. Talk to your doctor or pulmonologist about your symptoms — especially if you notice them worsening when it’s cold outside. They can help you come up with solutions or treatment options to manage your symptoms, even on chilly days.
Whenever you’re outside in cold weather, make sure you cover your nose and mouth. You can use a scarf, a mask, or any other garment. Creating a barrier over your nose and mouth warms the air that is entering your lungs, helping to prevent blood vessel constriction.
If you worry that you will forget to protect your nose and mouth from the cold, keep your face covering near the door or in the pocket of your jacket. That way, you’ll always have access to it when you need it. This can be especially helpful if the outside temperature suddenly drops or if you start to have trouble breathing.
Before you go outdoors when you know it’s going to be cold, warm up your lungs. Do some light exercises to make your heart pump a little faster and more energetically. This can be as simple as walking around your house a few times before you go outside.
This light exercise will have your heart working harder than normal by the time you go outside. When the cold hits your lungs, it will be in a better place to keep your body oxygenated, so you don’t wind up out of breath.
Even if your PH is mild, you may want to avoid being too active outside when it’s cold. One member offered this suggestion: “In colder weather, it is best to avoid strenuous activity, such as shoveling snow. Ask neighbors or friends to help clear your sidewalks and driveway.”
If you prefer not to ask for help, you may want to offer to pay a local teenager to do your shoveling. You can set up a system where they shovel your driveway each time it snows. If you would rather avoid going outside, you can arrange to leave money out for them in your mailbox or send them payment electronically.
No matter where you are or where you are going, you can plan to stay warm. If you’re at home, make sure you have adequate heating, blankets, slippers, a fireplace or additional space heaters, and more. If you’re going to be in the car, take blankets, hot water bottles, and plenty of layers of clothing so you can stay comfortable.
Because staying inside is the best way to stay warm when it’s cold outside, make sure that your indoor air quality is high. After all, dry air can irritate your lungs, and dust or allergens in your heating, ventilating, and air condition (HVAC) system can make breathing hard, too. You may need to install a humidifier and/or clean your air ducts so you can breathe easier this winter.
If you aren’t on medication for PH, talk to your doctor about treating it. There are many options:
The right medication for you will be determined by the cause of your PH, as well as other factors about your current medical situation.
There is at least one promising study looking at medications specifically designed for people whose PH gets worse when they are cold. These findings are currently preliminary and further studies are needed, but it’s worth asking your pulmonologist or health care team whether additional medication might help.
You may also want to participate in ongoing research by volunteering for clinical trials. This has benefits and drawbacks, so you’ll need to work with your doctor and the research team to find out if it is the best option for you to improve your quality of life.
By joining myPHteam, the social network for people with pulmonary hypertension, you can ask questions, share advice, and connect with more than 39,000 members who understand life with pulmonary hypertension. Before long, you’ll have a support group from around the world — those who understand what you’re going through.
Do you experience worse PH symptoms when it’s cold outside or with other weather changes? How do you manage it? Share your experience and tips in the comments below or by posting on myPHteam.
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