{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:57:45Z","timestamp":1785430665785,"version":"3.56.0"},"reference-count":238,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Agency for Administration of University and Research","award":["2021-SGR-00350"],"award-info":[{"award-number":["2021-SGR-00350"]}]},{"award":["2021-SGR-00350"],"award-info":[{"award-number":["2021-SGR-00350"]}],"id":[{"id":"https:\/\/ror.org\/01n4pqe45","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003741","name":"Catalan Institution for Research and Advanced Studies","doi-asserted-by":"publisher","award":["ICREA_Academia\u2013Prize-2021"],"award-info":[{"award-number":["ICREA_Academia\u2013Prize-2021"]}],"id":[{"id":"10.13039\/501100003741","id-type":"DOI","asserted-by":"publisher"}]},{"award":["ICREA_Academia\u2013Prize-2021"],"award-info":[{"award-number":["ICREA_Academia\u2013Prize-2021"]}],"id":[{"id":"https:\/\/ror.org\/0371hy230","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Cardiovascular diseases (CVDs) remain the leading global cause of morbidity and mortality, imposing an increasing clinical and socioeconomic burden. Despite significant therapeutic advances, optimal control of risk factors and long-term outcomes remain challenging, particularly in patients with complex comorbidities. This narrative review provides a comprehensive and up-to-date synthesis of pharmacological options across major cardiovascular domains, with a specific focus on hypertension, heart failure, arrhythmias, and hypertrophic cardiomyopathy, conditions in which hemodynamic, neurohormonal, and electrophysiological pathways play central roles. We summarize mechanisms of action, clinical evidence, safety profiles, and guideline-based indications of established therapies, highlighting their relevance to vascular tone regulation, neurohormonal modulation, endothelial signaling, and myocardial function, the mechanistic axes that intersect with pathways implicated in pulmonary vascular disease (PVD). In addition, we discuss emerging therapeutic targets and innovative agents such as renin-angiotensin-aldosterone system silencers, endothelin pathway modulators, SGLT2 inhibitors, soluble guanylate cyclase stimulators, myosin inhibitors, and other mechanism-based approaches. Current challenges and unmet clinical needs are examined in the context of translational relevance for PVD and the broader goal of advancing individualized pharmacotherapy. Continued therapeutic innovation targeting shared vascular, metabolic, and neurohormonal pathways holds promise for improving outcomes across both systemic and pulmonary vascular diseases.<\/jats:p>","DOI":"10.3390\/medsci14020331","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:04:04Z","timestamp":1781874244000},"page":"331","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Present and Future Options for Pharmacotherapy in Cardiovascular Disease: Hemodynamic and Mechanistic Therapeutic Targets"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8593-7147","authenticated-orcid":false,"given":"Francesc","family":"Cabr\u00e9","sequence":"first","affiliation":[{"name":"Department of Biochemistry & Molecular Biomedicine, University of Barcelona, 08028 Barcelona, Spain"},{"name":"Medical Area, Menarini Group, 08918 Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2062-4633","authenticated-orcid":false,"given":"Marta","family":"Cascante","sequence":"additional","affiliation":[{"name":"Department of Biochemistry & Molecular Biomedicine, University of Barcelona, 08028 Barcelona, Spain"},{"name":"Biomedicine Institute, University of Barcelona, 08028 Barcelona, Spain"},{"name":"CIBER of Hepatic and Digestive Diseases (CIBERHD), Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, May 01). 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