Advances in the pathogenesis and clinical management of pulmonary hypertension

Pulmonary hypertension (PH) is a severe cardiopulmonary disorder characterized by pulmonary vascular remodeling, which leads to increased pulmonary vascular resistance (PVR), right ventricular (RV) hypertrophy, and ultimately heart failure and death. This review explores the dual landscape of PH, integrating recent insights into its complex pathogenesis with evolving clinical management strategies. The pathogenesis of PH involves a complex interplay of genetics, metabolism, immune dysfunction, biomechanical force and other factors, all contributing to vascular remodeling and presenting opportunities for novel therapies and biomarkers. Among these, certain pathogenic mechanisms are of particular relevance and may hold distinct importance in the pediatric population. Concurrently, notable progress has been made in clinical front including diagnosis, risk stratification, drug development, interventional or surgical procedures, and imaging technologies. Hence, this review integrates current evidence in both PH pathogenesis and clinical management to guide future research toward novel therapies and precision medicine.