FIGURE 1.

A genetic predisposition combined with environmental risk factors may be involved in the development of pulmonary arterial hypertension (PAH). In individuals without mutations in PAH-associated genes (genetically non-susceptible), epigenetic changes and exposure to environmental triggers over time can result in progressive pulmonary vascular dysfunction. This process is accelerated in individuals carrying mutations in PAH-associated genes (genetically susceptible). Reproduced and modified from [8] with permission from the publisher.