What is the most important factor contributing to the onset of pulmonary hypertension in the pa-tient with COPD?
a. Alveolar hypoxia
b. Compression of pulmonary vasculature
c. Left ventricular failure
d. Loss of vascular surface
ANS: A
Alveolar hypoxia, because of its potent pulmonary vasoconstrictive effect, is probably the most important factor contributing to pulmonary hypertension in patients with COPD. Sustained alve-olar hypoxia causes pulmonary vasoconstriction and eventually medial hypertrophy, fibrosis of the intima, and narrowing of the lumen of the pulmonary blood vessels.
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