When most people hear the term “high blood pressure,” they think of the number they see at their annual checkup — the one measured with a cuff around their arm. What many don’t realize is that there is another type of high blood pressure that affects the lungs and heart in a very different way. Pulmonary hypertension, while less well-known, is a serious condition that requires its own unique approach to diagnosis and treatment. Understanding the differences between the two can help you recognize symptoms early and seek the right care.

What is regular high blood pressure?

Regular high blood pressure — also known as systemic hypertension — occurs when the force of blood pushing against the walls of your arteries throughout your body is consistently too high. It is one of the most common chronic conditions in the United States, affecting nearly half of all adults.

Systemic high blood pressure is typically:

  • Measured easily – detected with a standard blood pressure cuff during a routine office visit
  • Often symptomless – many people don’t know they have it until it’s found during a checkup, which is why it’s often called “the silent killer”
  • Managed with lifestyle and medication – dietary changes, exercise, weight management, and commonly prescribed medications are usually very effective
  • Widespread – it is one of the most frequently diagnosed conditions in primary care

What is pulmonary hypertension?

Pulmonary hypertension (PH) is high blood pressure that specifically affects the arteries in the lungs and the right side of the heart. In a healthy body, blood flows from the right side of the heart into the lungs at relatively low pressure to pick up oxygen. When the pulmonary arteries become narrowed, stiffened, or blocked, the pressure in those vessels rises, forcing the right side of the heart to work much harder than it should. Over time, this extra strain can weaken the heart and lead to serious complications.

Pulmonary hypertension is typically:

  • Harder to detect – it cannot be measured with a standard blood pressure cuff and often requires specialized testing such as an echocardiogram or right heart catheterization
  • Symptomatic but easily overlooked – symptoms like shortness of breath, fatigue, and dizziness are often mistaken for other conditions or attributed to aging
  • Classified into five groups – PH has multiple underlying causes, including heart disease, lung disease, blood clots, and other medical conditions, and treatment depends on the specific type
  • Less common but serious – while not as widespread as systemic hypertension, pulmonary hypertension can be life-threatening if left untreated

Key differences patients should know

Despite sharing the term “high blood pressure,” these two conditions differ in important ways:

  • Location – systemic hypertension affects the arteries throughout the body, while pulmonary hypertension affects the arteries in the lungs specifically
  • Diagnosis – regular high blood pressure is found with a simple arm cuff reading, while pulmonary hypertension requires specialized cardiac and pulmonary testing
  • Symptoms – systemic hypertension is often silent, whereas pulmonary hypertension typically presents with noticeable symptoms such as shortness of breath during everyday activities, chest pressure, swelling in the ankles or legs, and fatigue
  • Treatment approach – while systemic hypertension is commonly managed with widely available medications and lifestyle modifications, pulmonary hypertension often requires targeted therapies prescribed by a specialist
  • Impact on the heart – systemic hypertension primarily strains the left side of the heart, while pulmonary hypertension places significant stress on the right side of the heart

When should you talk to your doctor?

Many of the early symptoms of pulmonary hypertension — like feeling winded going up a flight of stairs, unusual fatigue, or a racing heartbeat — can be easy to brush off. But if you notice that everyday activities are becoming harder than they used to be, or if you experience any unexplained shortness of breath, swelling, or chest discomfort, it’s important to bring it up with your healthcare provider. Early detection makes a significant difference in managing pulmonary hypertension effectively.

“Pulmonary hypertension can be a diagnosis unto itself, or it can be associated with an array of common and uncommon respiratory and cardiac diseases. If you have shortness of breath or difficulty getting around due to breathing problems, you always want to make sure that pulmonary hypertension has been evaluated for, and ruled-in or ruled-out.”— Andrew Weber, MD, FCCP, Medical Director, Critical Care | Medical Director, Pulmonary Rehabilitation

Taking the next step

Whether you’re experiencing new symptoms or simply want to learn more about your lung and heart health, talking with a specialist is a great place to start. With advances in diagnosis and treatment, patients with pulmonary hypertension have more options than ever to manage their condition and maintain their quality of life.

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