Pulmonary hypertension is high blood pressure in the arteries that carry blood from the heart to the lungs. It makes the right side of the heart work harder and can lead to heart failure. Current treatments include drugs that relax blood vessels in the lungs, manage fluid buildup, and address underlying causes like blood clots or lung disease.
What's actually going on in research
Trials are testing drugs that target different pathways to relax lung blood vessels, including new formulations of existing medications and entirely new mechanisms. Researchers are studying whether treating the right ventricle directly can help the heart adapt. Studies also focus on pulmonary hypertension caused by lung disease and left heart disease, where treatment options remain limited.
Right ventricle treatments
Studies are testing whether protecting or strengthening the right ventricle can improve outcomes, even if lung pressures stay high. This represents a shift toward treating the heart itself, not just the lung vessels.
Combination therapies
Trials are testing whether starting multiple medications together works better than adding them one at a time. Early combination therapy might prevent disease progression more effectively.
Group 2 and 3 trials
Most approved drugs target pulmonary arterial hypertension, but new trials focus on types caused by left heart disease and lung conditions. These forms are more common but have fewer proven treatments.
What to know before you search
Eligibility typically depends on pulmonary hypertension type and cause, severity measured by right heart catheterization, current medications, and functional class measuring exercise capacity.
What types of trials are currently open
- Drug mechanism trials — Testing new medications that relax lung blood vessels through different biological pathways, often pills or inhaled treatments taken one to three times daily.
- Combination therapy trials — Comparing different combinations of existing medications to find the most effective regimens and timing.
- Heart function trials — Testing treatments aimed at helping the right ventricle pump more effectively or adapt to increased pressure.
- Group-specific trials — Studies focused on pulmonary hypertension caused by specific underlying conditions like lung disease, left heart disease, or chronic blood clots.
- Exercise and rehabilitation trials — Testing whether structured exercise programs, oxygen therapy, or pulmonary rehabilitation improve symptoms and function.
Recently added Pulmonary Hypertension trials
Randomized Study of Triple Therapy vs Sildenafil Dose Optimization in Pulmonary Arterial Hypertension
Pulmonary arterial hypertension (PAH) is a rare and progressive disease characterized by increased pressure in the pulmonary arteries, leading to right heart failure and premature death. Although combination therapy has improved outcomes, many patients remain at intermediate or high clinical risk despite treatment. When patients do not reach low-risk status, treatment escalation is recommended. However, different escalation strategies are used in clinical practice, including increasing the dose of existing medications or adding a third drug that targets a different biological pathway. There is limited prospective randomized evidence directly comparing these approaches. The ASCEND-PAH study is a prospective, randomized, open-label clinical trial designed to compare two therapeutic escalation strategies in adults with PAH who remain at intermediate or high risk despite dual therapy with an endothelin receptor antagonist and sildenafil. Participants will be randomized to either: (1) escalation to triple therapy with the addition of a prostacyclin pathway agent, or (2) optimization of dual therapy by increasing the dose of sildenafil. The primary objective is to compare the proportion of patients who improve their risk category according to the COMPERA 2.0 four-stratum risk model within 3 to 6 months after randomization. Secondary outcomes include changes in functional status, exercise capacity, biomarkers, clinical worsening, safety, and treatment persistence
Multimodality RV Phenotyping for Risk Stratification and Short-Term Outcomes in Group 1 PAH
The MIRROR-PAH is a single-center, prospective, observational cohort study evaluating the incremental value of multimodality imaging-derived right ventricular characteristics for risk stratification in patients with Group 1 pulmonary arterial hypertension (PAH). The study aims to determine whether incorporation of echocardiographic and cardiac magnetic resonance (CMR)-derived right ventricular parameters into established non-invasive risk assessment models results in risk reclassification and improves identification of patients at risk for short-term clinical worsening. Adult patients with established Group 1 PAH undergoing routine follow-up and with available right heart catheterization (RHC) and CMR data will be consecutively enrolled. Clinical, laboratory, echocardiographic, and follow-up data will be prospectively collected over a 6-month period. Associations between multimodality imaging findings, invasive hemodynamic measurements, risk classification, and short-term clinical outcomes will be evaluated.
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