Clinical research on pulmonary hypertension from a 2025 perspective: a narrative review.
Authors
Affiliations (1)
Affiliations (1)
- State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Health, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Abstract
Pulmonary hypertension (PH) is a clinical syndrome characterized by progressive elevation of pulmonary vascular resistance (PVR) and subsequent right ventricular (RV) failure. The research of PH has undergone unprecedented transformation in 2025, marked by paradigm-shifting therapeutic advances, refined diagnostic criteria, and sophisticated precision medicine approaches. This narrative review aims to synthesize the recent evidence from pivotal clinical trials, epidemiological studies, and translational research that collectively redefine the management of this complex disease spectrum, providing clinicians and researchers with an overview of current developments and future directions. The literature search was conducted in PubMed with particular focus on publications from January 2025 to December 2025. Inclusion criteria encompassed clinical trials, observational studies, registry analyses, and research articles reporting novel diagnostic approaches, biomarkers, therapeutic interventions, and management strategies for PH. Studies were selected based on their relevance to clinical practice and scientific significance. The selection process was conducted independently, with consensus reached through discussion for any discrepancies. The 2025 clinical research on PH evolved towards precision assessment driven by novel biomarkers and artificial intelligence (AI), enhanced imaging [echocardiography, computed tomography (CT), magnetic resonance imaging (MRI)] for improved detection, phenotyping, and risk stratification. Therapeutically, the treatment focus has shifted beyond vasodilation to attenuating pathological remodeling. Most notably, sotatercept, its validation in reduce clinical worsening expanded across diverse patient populations. Alongside, optimized use of classical pathways (endothelin, nitric oxide, prostacyclin) and emerging targeted therapies (e.g., seralutinib, imatinib) may bring more clinical benefits. Interventional therapies have been optimized through large-scale registries and patient-specific factors, while non-pharmacological strategies have gained recognition as essential components of multidisciplinary management. Furthermore, right ventricular targeted therapies have received increasing attention and improved outcomes for patients. The convergence of sophisticated risk stratification tools and mechanism-based therapeutics in 2025 established a robust foundation for improving survival and quality of life in PH patients.