Abstract: Pulmonary arterial hypertension (PAH) is a common clinical syndrome characterized by dysfunction of pulmonary
arterioles leading to increased vascular resistance and elevated pulmonary artery pressure. Insulin resistance (IR) is recognized
as a critical risk factor for cardiovascular disease, but recent evidence suggested an association between IR and PAH. The
pathological consequences of IR, such as hyperinsulinemia, dyslipidemia, chronic inflammation, and oxidative stress can cause
pulmonary vasoconstriction, endothelial dysfunction and vascular remodeling, which aggravate the progressive course of
PAH. Therefore, addressing the molecular mechanisms by which IR promotes the development of pulmonary hypertension
and searching for appropriate interventions are important in the management of PAH.