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Prevention

By Mayo Clinic staff

Pulmonary edema often isn't preventable, but these measures can help reduce your risk.

Preventing cardiovascular disease
Cardiovascular disease is the leading cause of pulmonary edema. You can reduce your risk of many kinds of heart problems by following these suggestions:

  • Control your blood pressure. High blood pressure (hypertension) can lead to serious conditions such as stroke, cardiovascular disease and kidney failure. Most adults should have their blood pressure checked at least once every two years. This is a noninvasive and painless procedure using an inflatable cuff that wraps around your upper arm. The test takes just a few minutes.

    A resting blood pressure reading below 120/80 millimeters of mercury (mm Hg) is considered normal. If your resting blood pressure is consistently 140/90 mm Hg or higher, you have high blood pressure. A reading in between these levels places you in the prehypertensive category.

    In many cases, you can lower your blood pressure or maintain a healthy level by getting regular exercise, eating a diet rich in fresh fruits, vegetables and low-fat dairy products, and limiting salt and alcohol.

  • Watch your blood cholesterol. Cholesterol is one of several types of fats essential to good health. But too much cholesterol can be too much of a good thing. Higher than normal cholesterol levels can cause fatty deposits to form in your arteries, impeding blood flow and increasing your risk of vascular disease. But lifestyle changes can often keep your cholesterol levels low. This includes limiting fats — especially saturated fats — eating more fiber, fish, and fresh fruits and vegetables, exercising regularly, stopping smoking, and drinking in moderation.
  • Don't smoke. If you smoke, the single most important thing you can do for your heart and lung health is to stop. Continuing to smoke increases your risk of a second heart attack or heart-related death and also increases your risk of lung cancer and other lung problems such as emphysema. What's more, you're at risk even if you don't smoke but live or work with someone who does. Exposure to secondhand smoke is a contributing factor to coronary artery disease. If you can't stop smoking by yourself, ask your doctor to prescribe a treatment plan to help you quit.
  • Eat a heart-healthy diet. Fish is one of the cornerstones of a heart-healthy diet — it contains omega-3 fatty acids, which help improve blood cholesterol levels and prevent blood clots. It's also important to eat plenty of fruits and vegetables, which contain antioxidants, vitamins and minerals that help prevent everyday wear and tear on your coronary arteries. Eat less fat, especially animal (saturated) and trans fats (hydrogenated oils).
  • Limit salt. It's especially important to use less salt (sodium) if you have heart disease or high blood pressure. In some people with severely damaged left ventricular function, excess salt — even in a single meal or a bag of chips — may be enough to trigger congestive heart failure. If you're having a hard time cutting back on salt, it may help to talk to a dietitian. He or she can help point out low-sodium foods as well as offer tips for making a low-salt diet interesting and good tasting.
  • Exercise regularly. Exercise is vital for a healthy heart. Regular aerobic exercise — about 30 minutes a day — helps control blood pressure and cholesterol levels, and maintain a healthy weight. If you're not used to exercise, start out slowly and build up gradually.
  • Maintain a healthy weight. Being even slightly overweight increases your risk of cardiovascular disease. On the other hand, even losing small amounts of weight can lower your blood pressure, cholesterol and reduce your risk of diabetes.
  • Consider taking baby aspirin. Talk to your doctor about the pros and cons of taking one baby aspirin (81 milligrams) a day.
  • Manage stress. To reduce your risk of heart problems, try to reduce your stress levels. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life.

Preventing HAPE
If you travel or climb at high altitudes, acclimate yourself slowly. Although recommendations vary, most experts advise ascending no more than 1,000 or 2,000 feet (300 to 600 meters) a day once you reach 8,000 feet (about 2,400 meters). In addition, it's important to drink plenty of water to stay hydrated. The higher you ascend the more rapidly you breathe, which means you lose larger amounts of water in the air you exhale from your lungs. Finally, although being physically fit won't necessarily prevent HAPE, people in good condition tend to be less stressed at high altitudes. Taken 12 to 72 hours before you travel to a high altitude, the medication acetazolamide (Diamox) can help prevent HAPE. Consider continuing the medication for an additional few days if any signs of altitude sickness, especially headache or insomnia occur.

Lifestyle and home remedies

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References
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  2. Schwartzstein RM. Dyspnea and Pulmonary Edema. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y. Mc-Graw Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2863220. Accessed June 4, 2009.
  3. Ware LB, et al. Acute pulmonary edema. New England Journal of Medicine. 2005;353:2788.
  4. Signs and symptoms of heart failure. American Heart Association. http://www.americanheart.org/print_presenter.jhtml?identifier=339. Accessed June 6, 2009.
  5. Harris MD, et al. High-altitude medicine. American Academy of Family Physicians. http://www.aafp.org/afp/AFPprinter/980415ap/harris.html?print=yes. Accessed June 6, 2009.
  6. O'Brien JF, et al. Heart failure. In: Marx JA, et al. Rosen's Emergency Medicine Concepts and Practice. Philadelphia, Pa.; Mosby Elsevier: 2006. http://www.mdconsult.com/das/book/body/141932241-3/849416907/1365/226.html#4-u1.0-B0-323-02845-4..50085-8--cesec4_3780. Accessed June 6, 2009.
  7. What causes cardiomyopathy? National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cm/cm_causes.html. Accessed June 6, 2009.
  8. What is ARDS?  National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_All.html. Accessed June 4, 2009.
  9. Givertz MM. Noncardiogenic pulmonary edema. http://www.uptodate.com/home/index.html. Accessed June 5, 2009.
  10. Swenson ER. Pathogenesis of high-altitude pulmonary edema: Inflammation is not an etiologic factor. Journal of the American Medical Association. 2002; 287: 2295
  11. Mattu A, et al. Modern management of cardiogenic pulmonary edema. Emergency Medicine Clinics of North America. 2005;23:1105
  12. Acetazolamide (Prescribing information). Haifa Bay, Israel. Taro Pharmaceuticals, Inc. http://www.taro.com/media/oMedia/Acetazolamide%20Tablets%20%200305-1.pdf. Accessed June 6, 2009.
  13. ABCs of Preventing Heart Disease, Stroke and Heart Attack. American Heart Association. http://americanheart.org/presenter.jhtml?identifier=3035374. Accessed June 6, 2009.
  14. How do I know if I have high blood pressure. American Heart Association. http://www.americanheart.org/print_presenter.jhtml?identifier=219. Accessed June 6, 2009.
  15. About high blood pressure. American Heart Association. http://www.americanheart.org/print_presenter.jhtml?identifier=468. Accessed June 6, 2009.
  16. How can I reduce high blood pressure? American Heart Association. Accessed June 6, 2009.
  17. Cigarette smoking and cardiovascular disease. American Heart Association. http://www.americanheart.org/print_presenter.jhtml?identifier=4545. Accessed June 6, 2009.
  18. Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. June 12, 2009.
  19. Grogan M (expert opinion). Mayo Clinic. Rochester, Minn. June 12, 2009.

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July 31, 2009

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