Its potential lies in addressing key pathological processes linked to PH development, such as inflammation, while simultaneously enhancing endothelial function and mitigating vascular remodeling.256,257 Endothelial AMPK downregulation in PAH patients and hypoxia-PH mice has been shown to accelerate the disease progression.244 Omura et al. revealed that targeting AMPK with metformin attenuates PH by reducing inflammation, emphasizing AMPK as a novel therapeutic target for PAH treatment. This evidence concerns the gene PRKAA1 and pulmonary arterial hypertension.