Rewriting the vascular script: epigenetic modifiers as scribes of metabolic reprogramming in pulmonary hypertension.

Pulmonary hypertension (PH) is a life-threatening cardiovascular condition marked by the remodeling of pulmonary vasculature. Existing treatments provide limited efficacy, emphasizing the urgent need for deeper scientific exploration. This review investigates how vascular cell dysfunction and metabolic reprogramming contribute to PH pathology, with a focus on the interplay between epigenetic modifications and cellular metabolism. Epigenetic abnormalities are shown to influence the expression of key metabolic enzymes, shedding light on their potential as drivers of metabolic dysregulation in PH. By elucidating alterations in glucose, lipid, and amino acid metabolism in vascular cells, this study highlights epigenetic modifications as promising targets for therapeutic intervention. Additionally, it examines the feasibility of correcting these reversible epigenetic changes to mitigate disease progression. This review concludes with an assessment of the challenges and opportunities in leveraging epigenetic and metabolic insights to develop novel PH treatments.