Question: I am 50 years old. Heavy drinker for many years, but recently quit. Hypertension for several years but blood pressure medicine now has that under control. Been working out several months and have reduced weight from 214 to 185 pounds (I'm 5'9 1/2 inches but muscular). Run/walk at least four miles a day now. Lipid panel last taken back in Jan/2015 and moderately elevated. Recent blood work within normal limits accept for enlarged red blood cells on CBC, which seems to be consistent with alcohol abuse. Total cholesterol 239. HDL was 42, LDL was 145. Triglycerides were 260. I expect that to approve significantly next lipid test with recent weight loss, exercise, eating healthy, and abstinence from alcohol consumption. I have no hereditary heart disease in my family. I should also tell you I have had very severe sleep apnea all my life, but finally started CPAP about 10 years ago. I know I had sleep apnea since I was a child, and wonder if that did damage to my heart for first 40 years. I really don't have much in the way of heart symptoms, accept for very occasional extremely mild chest pressure and extremely mild heavier breathing maybe walking up a few flights of stairs. But my breathing actually feels better when I work out. Most of my very mild symptoms I think are more related to years of heavy daily drinking and daily anxiety. I am also a type A high anxiety guy. My question is, I recently had resting echo test that I am concerned with. I have RBBB, and had nuclear stress test Jan/2015 and everything came back completely normal. But recent echo test taken August 2015 showed;

Mild atrial enlargement
Moderate RV enlargement
Normal LV thickness and systolic wall motion, estimated ejection fraction =55-60%
No pericardial effusion
Normal RV thickness and systolic wall motion
Normal appearing valves
Trace of Tricuspid regurgitation

What might be causing this and should it be of concern? And assuming RV enlargement is correct, can it be reversed? Cardiologist wants to do Transesophageal Echocardiography next month. Any thoughts on what my condition could be and what questions to ask cardiologist after procedure?

Since I really don't have much in the way of current symptoms, have quit drinking, and have been using CPAP last 10 years, is it possible to keep pulmonary hypertension (assuming that is what I have) under control for many years assuming healthy lifestyle? Or will it get progressively worse regardless?

And if it will get progressively worse regardless of healthy lifestyle, are there things they can do to to slow it down or keep it from getting worse and possibly live somewhat normal life span?

I would greatly appreciate a straight honest answer so I know what I might be possibly dealing with moving forward. Thanks