When it comes to hypertension, both doctors and the general public are highly aware of its prevention and treatment, but most people, including physicians, neglect to pay attention to another kind of “hypertension”, which is pulmonary hypertension. Pulmonary hypertension is a very low incidence disease, but it has become a killer of young people. Medical experts warn young people to pay attention to this disease, the average age of onset of the disease is only 36 years old, if left untreated, survival time is only two to three years. More frighteningly, due to the low incidence of this disease, general practitioners are not sufficiently aware of it and the misdiagnosis rate is extremely high, often delaying diagnosis and treatment, and patients thus miss early treatment. Most patients with pulmonary hypertension have an insidious onset and develop slowly. At first, there are no specific symptoms and there may only be some shortness of breath and chest tightness, which can improve after rest, so it is not easy to draw attention to the disease. Later on, with further increase of pulmonary artery pressure, shortness of breath, chest pain, dizziness and easy syncope may appear. Severe patients develop symptoms of right heart failure, such as edema of the lower limbs, enlarged liver, and even ascites or pleural fluid. Once the symptoms of right heart failure appear, the prognosis of patients is not optimistic. According to NIH statistics, the median survival rate of patients from the diagnosis of idiopathic pulmonary hypertension is generally 2 to 3 years, and the 5-year survival rate of those without treatment is less than 25%, which is shorter than the survival time of many malignant tumors. Moreover, the quality of life of patients is poor, often unable to take care of themselves and requiring family care. Therefore, it is important to be alert to this highly disabling and high mortality disease. Conventional sphygmomanometers cannot measure pulmonary hypertension. The vast majority of pulmonary hypertension is detected by echocardiography, and accurate measurement of pulmonary artery pressure requires right heart catheterization, which measures pressure directly in the pulmonary artery and gives the most accurate results. Therefore, when pulmonary hypertension is detected, it is best to go to the hospital for a right heart catheterization to clarify the diagnosis. Pulmonary hypertension is both a disease and can be a manifestation of other diseases. Which diseases or which factors can cause pulmonary hypertension? According to the latest international classification, pulmonary hypertension can be divided into five major categories, and more than thirty diseases can cause it. These include idiopathic pulmonary hypertension, connective tissue diseases such as rheumatoid arthritis and systemic lupus erythematosus. Due to environmental pollution and other reasons, pregnant mothers are exposed to various risk factors, leading to a significantly higher incidence of various congenital heart diseases, such as patent ductus arteriosus, atrial septal defect, and ventricular septal defect, which can develop into pulmonary hypertension if they are not treated promptly and effectively. The highest patients may even develop a pressure in the pulmonary circulation that is greater than the pressure in the body circulation (normally the pressure in the pulmonary circulation is only one-fifth of that in the body circulation), and once this occurs the opportunity for surgery or intervention is lost. Outpatients with unexplained chest tightness and shortness of breath are often examined and found to have pulmonary hypertension. Further examination reveals pulmonary thromboembolism, which is prone to occur in elderly patients with varicose veins in the lower extremities, who are bedridden for a long time and have little activity. There are relatively few treatment options for pulmonary hypertension. In recent years, with the in-depth research on the disease, the successful development of some new drugs, such as prostacyclin and endothelin receptor antagonists, has brought hope to patients with pulmonary hypertension, and some doctors at home and abroad have achieved better results using phosphodiesterase inhibitors. Due to the insidious onset of pulmonary hypertension, the previous limitations of the level of diagnosis, and the lack of safe and effective drug treatment, many patients spent the rest of their lives in pain and despair. Now, with the improvement of the level of diagnostic technology and the launch of many new drugs, the treatment of pulmonary hypertension is no longer just a dream, and it is believed that people’s awareness of pulmonary hypertension and the treatment of pulmonary hypertension in the future can achieve good diagnostic and treatment results toward hypertension.