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It is characterized by changes in endothelial cell function and smooth muscle cell proliferation in the pulmonary arteries, causing persistent vasoconstriction, resulting in right heart hypertrophy and failure. There are multiple drug classes specific to PAH treatment, but variation between patients may impact treatment response. A small subset of patients is responsive to pulmonary vasodilators and can be treated with calcium channel blockers, which would be deleterious if prescribed to a typical PAH patient. Little is known about the underlying cause of this important difference in vasoresponsive PAH patients. Sex, race\/ethnicity, and pharmacogenomics may also factor into efficacy and safety of PAH\u2010specific drugs. Research has indicated that endothelin receptor antagonists may be more effective in women and there have been some minor differences found in certain races and ethnicities, but these findings are muddled by the impact of socioeconomic factors and a lack of representation of non\u2010White patients in clinical trials. Genetic variants in genes such as <jats:italic>CYP3A5<\/jats:italic>, <jats:italic>CYP2C9<\/jats:italic>, <jats:italic>PTGIS<\/jats:italic>, <jats:italic>PTGIR<\/jats:italic>, <jats:italic>GNG2<\/jats:italic>, <jats:italic>CHST3<\/jats:italic>, and <jats:italic>CHST13<\/jats:italic> may influence the efficacy and safety of certain PAH\u2010specific drugs. PAH research faces many challenges, but there is potential for new methodologies to glean new insights into PAH development and treatment.<\/jats:p>","DOI":"10.1002\/pul2.12304","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T12:22:43Z","timestamp":1698927763000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Differential drug response in pulmonary arterial hypertension: The potential for precision medicine"],"prefix":"10.1002","volume":"13","author":[{"given":"Elise","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice and Science University of Arizona R. Ken Coit College of Pharmacy  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinwuwanuju Ugo\u2010Obi","family":"Sampson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science University of Arizona R. 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