
Pulmonary hypertension is an enigmatic, deleterious disease driven by multiple heterogeneous causes with a burgeoning proportion of older patients with complex, chronic comorbidities without adequate treatment options. The underlying endothelial pathophenotypes that direct vasoconstriction and panvascular remodeling remain controversial and incompletely defined. This review discusses emerging concepts centred on endothelial senescence in pulmonary vascular disease. This principle proposes a more heterogeneous, dynamic pulmonary endothelium in disease; it provides a potentially unifying feature of endothelial dysfunction in pulmonary hypertension irrespective of the cause. It supports a clinically relevant link between ageing and pulmonary hypertension like other chronic illnesses. Thus, taking cues from studies on ageing and age-related diseases, the study presents possible opportunities and barriers to diagnostic and therapeutic targeting of senescence in pulmonary hypertension.
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