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Certain heart diseases. Heart diseases, including aortic valve disease, left heart failure, mitral valve disease, and congenital heart disease, can also cause pulmonary hypertension. Thromboembolic disease. A blood clot in a large pulmonary artery can result in the development of pulmonary hypertension.
Polycythemia is also associated with hypertension due to increased blood viscosity and thrombosis. Severe, chronic polycythemia secondary to increased blood viscosity can raise pulmonary arterial pressure and cause increased pulmonary resistance with potential hypoxia, resulting in cor pulmonale. Thus, increased hemoglobin and hematocrit secondary to testosterone replacement can be significant and in a recent meta-analysis has been cited as the most common side effect of androgen therapy