High-level clinical research promotes the development of risk stratification for pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a rare and critical cardiovascular disease characterized by increased pulmonary vascular resistance, lesions in the pulmonary arterioles, and a subsequent rise in the right ventricular load, which inevitably leads to right heart failure. Unfortunately, patients with PAH have a poor prognosis, with a median survival time of 2.8 years under traditional drug therapy when there are no targeted pharmaceuticals, earning it the reputation of being a cancer of the cardiovascular system. Patients with PAH face significant challenges. They usually show nonspecific clinical manifestations in the early stages, which often leads to delayed diagnosis and treatment. The majority of the population with PAH in China are young and middle-aged females. Apart from physical difficulties, these patients may have a poor quality of life despite adequate drug treatment. Many patients experience anxiety, depression, or other psychological disorders. These burdens not only affect patients but also place immense strain on their families and society. The current 5year survival rate for critically severe patients with PAH receiving optimal drug treatment is only 33.3%. To address these challenges, risk assessment plays a crucial role in guiding the clinicians' decision-making processes, treatment evaluation, and prognosis prediction for patients with PAH. However, establishing effective risk stratification requires extensive clinical research. High-level clinical research can serve as a means of solving clinical problems and we can gain insights into the process and methods involved. The Chinese PAH cohort represents a unique opportunity to study international experiences in the development of a risk stratification system suitable for the Chinese population. By systematically outlining the development of PAH from its first description as a disease, which garnered attention from the World Health Organization, we appreciate the importance of conducting clinical research that has helped enhance our understanding of this disease. Establishing prognostic prediction equations through clinical studies and conducting international research on risk stratification in the era of targeted drug therapy are vital steps for continuously updating risk stratification guidelines and treatment concepts. The development of high-level clinical research in China can draw inspiration from these processes. By leveraging lessons learned from international experiences, we can pave the way for advancements in PAH research within the country. This included addressing the current application status and challenges faced in the implementation of risk stratification for PAH in China. Future research should focus on refining the risk stratification methods, exploring innovative diagnostic techniques, and identifying novel treatment approaches for PAH. By continuously enhancing our understanding of this complex disease, we can improve patient outcomes and alleviate the burden on individuals, families, and the society as a whole. In conclusion, PAH presents significant challenges in diagnosis, treatment, and risk assessment. By delving into high-level clinical research to address these challenges, we can pave the way for improved management strategies and better outcomes for patients with this devastating condition. Through international collaborations and tailored approaches for the Chinese population, we can strive towards more accurate risk stratification and ultimately enhance the overall care provided to individuals with PAH.