Living with Pulmonary Arterial Hypertension

• Since each person is different, there is no set diet that is sure to help reduce the symptoms of the disease. You should eat healthily to maintain energy and try to reach a healthy weight. If significant weight gain or loss is observed, it must be reported to the medical team.  
• Salt-free diet. You should reduce your salt intake to prevent or reduce fluid retention. Salt contains sodium, which is mainly responsible for the balance of fluids in the body. Eating too much salt can increase the volume of blood your heart has to pump, increasing blood pressure. Ready meals or pre-packaged meals should be avoided, and it is essential to eat fresh fruit, vegetables, whole grains, fish and meat. Eat small meals frequently.
• Prevent constipation. To avoid overexertion, foods rich in vegetable fibre, such as natural nuts, cereals, whole wheat bread or fruit, such as plum or oranges, must be included in the diet.

Tips to reduce salt intake:

•    Reduce the amount of salt you eat every day until it is completely eliminated.

•    Enhance the flavour of food by cooking with steam, in the oven, en papillote, with a grill or using new seasonings and aromatic herbs.

•    Read the product labels and choose the ones that are low in sodium.

Physical activity should be limited according to symptoms. If you want to incorporate exercise into your daily routine, consult with your healthcare team. Recent studies have been made on introducing exercise for patients with pulmonary hypertension to increase strength and thus maintain a good physical level. At the moment, many referral centres are incorporating supervised cardiopulmonary rehabilitation programmes.

It is common to have shortness of breath while sleeping. Sleeping in a raised upper body position can help you breathe easier. To do this, you should use pillows that raise the entire trunk and not just the head or neck. If you have a fold-down bed, you can also raise your feet. To improve breathing and oxygenation in a resting situation, relaxation techniques and deep breathing can be used, as well as breathing exercises and sighs before going to sleep to improve ventilation.

When planning holidays, some guidelines must be followed to avoid the complications of the disease.

• Ensure access to a nearby hospital or centre where you can go if a problem occurs.  
• Bring reports and contact telephone numbers of your reference centre.  
• Prepare all your medication, and take more than you expect to need in case there are complications or delays.  
• Avoid extreme temperatures.  
• Avoid immersing yourself in hot springs or going to a sauna, as it can cause a severe drop in blood pressure.  
• Patients who carry catheters for administration of medication must not enter bodies of water.
• Avoid tourist destinations that are located over 1,000 m above sea level.  
• Air travel is contraindicated in many patients. Before considering taking a plane trip, you should always consult the reference centre team to assess the situation.  
• If you need to take oxygen, you must inform the travel or flight operators at the time of booking, and arrange a transfer to the airport with the medical service, if required.

Living with the symptoms of pulmonary hypertension can have an emotional impact on patients, who may feel depressed, frustrated, distressed or lacking in motivation. Support from family and friends, as well as from professionals and patient associations, can be of great help.