From Pathways to Patients: Contemporary Approaches to Pulmonary Hypertension

Pulmonary hypertension (PH) is a heterogeneous and progressive condition defined by elevated mean pulmonary arterial pressure, classified into 5 groups based on underlying etiology and pathophysiology. Affecting millions worldwide, PH carries a poor prognosis, particularly in pulmonary arterial hypertension (group 1). From a cardiology perspective, advancing PH management is essential given the central role of the pulmonary circulation and right ventricular function in cardiovascular homeostasis. Current management emphasizes accurate diagnosis via right heart catheterization, comprehensive risk stratification using models, and the integration of supportive measures. Pharmacologic strategies are constantly evolving, currently including antiproliferative vascular remodeling therapies. Treatment algorithms now favor early combination therapy and dynamic escalation guided by risk assessment. Advanced and interventional options remain vital for select patients. Long-term care requires multidisciplinary coordination, specialized PH centers, and integration of rehabilitation and palliative support. This review discusses the current evidence of PH management, evidence gaps, and future research directions.