Pulmonary Hypertension: Intensification and Personalisation of Combination Rx

This trial is exploring whether personalizing and intensifying medication combinations can improve outcomes for people with a specific type of high blood pressure in the lungs (pulmonary arterial hypertension, or PAH) who are not responding well enough to their current treatment. **You may be eligible if...** - You are 18–80 years old - You have been diagnosed with PAH (idiopathic, inherited, or related to drugs, toxins, or connective tissue disease) - You are already on a stable combination of PAH medications including an endothelin receptor antagonist and a PDE5 inhibitor - Your PAH is classified as WHO functional class III (significant symptoms limiting activity) - You can walk more than 50 metres in a 6-minute walk test - Your kidney function is adequate **You may NOT be eligible if...** - You have a history of unprovoked blood clots in the lungs - Your PAH is caused by HIV, liver disease, or congenital heart disease - You have pulmonary hypertension from other causes (heart disease, lung disease, etc.) - You have significant kidney disease - You have anaemia (low haemoglobin below 10 g/dL) - You have significant heart valve disease - You are allergic to aspirin, selexipag, or riociguat Talk to your doctor to see if this trial is right for you.