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Managing Allergies and Pulmonary Hypertension

Updated on September 07, 2021
Medically reviewed by
Steven C. Pugliese, M.D.
Article written by
Aminah Wali, Ph.D.

In people with pulmonary hypertension (PH), treating seasonal allergies can be tricky. This can be due to a number of reasons, including allergy symptoms being worsened by the condition and complications from PH medications.

Common Symptoms of Pulmonary Hypertension

Pulmonary hypertension is high blood pressure caused by impacted blood flow through the lungs and the right side of the heart. In pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension, the pulmonary arteries in the lung are specifically impacted. The condition can cause symptoms such as:

  • Chest pain or tightness
  • Dizziness
  • Fatigue
  • Shortness of breath

PH is also associated with lung diseases such as chronic obstructive pulmonary disease and interstitial lung disease. These diseases may cause additional symptoms such as:

  • A persistent cough with increased mucus
  • Respiratory problems
  • Wheezing

Chronic pulmonary heart disease, which can arise as a complication of prolonged damage caused by lung disease and PH, can also potentially cause respiratory problems.

How Can Allergies Impact Pulmonary Hypertension?

Seasonal allergies, also called allergic rhinitis, cause common symptoms such as a runny nose, itchy eyes, sneezing, a scratchy throat, and coughing. Due to the impact of allergies on airways, there is evidence that allergic rhinitis is linked to worsening of PH symptoms.

Some of the symptoms caused by PH itself, including dry cough and shortness of breath, are also similar to those caused by allergies.

In addition, many symptoms of PH are similar to those caused by asthma. Asthma symptoms are often exacerbated during allergy season, as expressed by members of myPHteam.

“I have sinus problems, breathing issues, and I’m hurting all over,” said one member.

“Had a sinus headache all day. Was very fatigued,” said another.

“I have mild asthma related to my allergies that has been bothering me for quite a while,” explained another member.

Complications of Pulmonary Hypertension Medications

To prevent heart failure, PH must be treated promptly. However, some medications designed to treat symptoms of PH have known side effects that mimic allergy symptoms, such as nasal congestion. These medications include endothelin receptor antagonists like Tracleer (bosentan), Letairis (ambrisentan), and Opsumit (macitentan), as well as phosphodiesterase 5 inhibitors like Revatio (sildenafil).

One myPHteam member was perplexed about a “chronic stuffy nose, cough, and shortness of breath after four months on sildenafil.”

Another member complained of “sinus problems, allergies, and congestion” from their medication.

“Been coughing a lot lately,” reported another member.

Another responded, “Could be a symptom of PH — it was one of the first questions I was asked during my diagnosis.”

Contact your health care provider immediately if you have persistent breathing problems or dizziness.

Treating Allergies With Pulmonary Hypertension

Identifying seasonal allergy triggers starts with allergy testing. Nasal corticosteroids, sold over the counter as Claritin (loratadine), Zyrtec (cetirizine), or Allegra (fexofenadine), are first-line medicines for reducing inflammation in the nasal cavities, followed by antihistamines.

As one myPHteam member bluntly put it, “Ugh! Pollen through the roof! Allergies kicking in — miserable!”

People with PH are advised to follow a few tips to help make allergy season more manageable:

  • Avoid seasonal allergy medications that constrict blood vessels, such as over-the-counter decongestants Sudafed (phenylephrine) and nasal spray Afrin (oxymetazoline).
  • Limit exposure to known irritants and allergens.
  • Consider using a nasal lubricant.

Medications such as antihistamines may help manage allergy symptoms in people living with PH. Be sure to consult with your doctor before starting or changing allergy medications.

Talk With Others Who Understand

On myPHteam, the social network for people with pulmonary hypertension and their loved ones, more than 37,000 members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.

Are you dealing with allergies and pulmonary hypertension? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Steven C. Pugliese, M.D. is affiliated with the Hospital of the University of Pennsylvania in Philadelphia, serving as the director of the pulmonary embolism response team, co-director of the comprehensive pulmonary embolism program, and an assistant professor of clinical medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Aminah Wali, Ph.D. received her doctorate in genetics and molecular biology from the University of North Carolina at Chapel Hill. Learn more about her here.

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