One Health Insights into Pulmonary Hypertension: Bridging Human and Canine Medicine

Pulmonary hypertension is a progressive syndrome characterised by pulmonary vascular dysfunction, inflammation, maladaptive remodelling, and progressive right-ventricular strain. Translational progress remains limited because experimental models reproduce only selected aspects of the complexity of human disease. This narrative review evaluates naturally occurring canine disease as a comparative and spontaneous model of human pulmonary hypertension within a One Health framework. To achieve this, we synthesise recent human and veterinary literature, international consensus statements, and key registry and imaging studies. We outline current human definitions and diagnostic pathways based on right-heart catheterisation, together with the veterinary probability-based approach centred on echocardiography; compare epidemiology across species; and summarise contemporary mechanisms spanning vascular dysfunction, immune and metabolic signalling, and right-ventricular adaptation. We then examine canine conditions that parallel major human pulmonary hypertension phenotypes, including left-heart disease due to myxomatous mitral valve degeneration, fibrotic interstitial lung disease in West Highland White Terriers, sleep-related airway obstruction in brachycephalic breeds, and rare venous and capillary disorders. When combined, these spontaneous models provide opportunities to investigate disease-modifying techniques other than vasodilation and allow for the longitudinal, real-world evaluation of imaging, functional assessments, and circulating biomarkers. To improve care for both veterinary and human patients, we conclude by outlining priorities for mechanism-based clinical trials, shared outcome measures, prospective registries and biobanks, and harmonised definitions.