An emerging strategy for targeted therapy of pulmonary arterial hypertension: Vasodilation plus vascular remodeling inhibition.

• The pathology of PAH is characterized by increased mPAP and elevated PVR on account of vasoconstriction and vascular remodeling. • Current medications primarily vasodilate with less consideration of vascular remodeling, leading to the clinical needs are still not met and PAH remains not curative. • The anti-vascular remodeling drugs failed to quickly reduce the patient's PAP in treating PAH clinically. • Emerging novel therapeutic approaches in PAH treatment with dual activities of vasodilation and vascular remodeling inhibition exert enormous advantages. Pulmonary arterial hypertension (PAH) is a rapidly progressing disease with limited therapeutic options. Studies have elucidated the multifactorial pathological characteristics of PAH, indicating the complexity and difficulty of PAH treatment. Currently available treatments focus primarily on vasodilation rather than on vascular remodeling, although several drugs have been developed for the latter. This paradigm for management leads to PAH remaining an incurable disease; thus, there is an urgent need to explore new strategies for coping with this devastating disease. In this review, we discuss current strategies and options for PAH therapy and emerging novel therapeutic approaches in PAH treatment. This viewpoint suggests a shift in PAH treatment strategy from mono-activity to dual effects on vasoconstriction and vascular remodeling. [ABSTRACT FROM AUTHOR]