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Pulmonary vascular mechanics: important contributors to the increased right ventricular afterload of pulmonary hypertension

•  What is the topic of this review? This article reviews pulmonary vascular and right ventricular (RV) changes due to hypoxic pulmonary hypertension (HPH), which is a type of pulmonary hypertension (PH) found clinically and has been widely used to induce PH in animal models. As research into clinical PH progression broadens to include RV as well as pulmonary vascular remodelling, an improved understanding of the effects of HPH on the RV is required. •  What advances does it highlight? This article highlights the moderate, adaptive and reversible nature of RV and pulmonary vascular remodelling in HPH. Moreover, we show that increased haematocrit in HPH contributes significantly to RV overload, which warrants additional attention.