|Inclusion criteria||Exclusion Criteria|
▪ Adults (18+) with confirmed PH (groups 1 to 5) as detailed in ESC/ERS guidelines .|
▪ Clinically stable: Groups 1, 4, & 5 - stable on optimal PH specific drug therapy (for those in whom it is appropriate) for at least one month, or evidence that these drugs cannot be tolerated. Groups 2 & 3 - stable on drug therapy for underlying cardiac or pulmonary disease for at least one month. Clinical stability defined as: presenting with, reproducible, manageable symptoms, not requiring any treatment other than routine follow-up care, and no PH related hospital admission in the last four weeks.
▪ World Health Organisation (WHO) functional class II, III or IV.
▪ Fluent in spoken English to allow engagement with intervention and physical outcome measures.
▪ Live within reasonable travelling distance (as defined by the participant) of a SPHERe exercise rehabilitation centre.
▪ Ability to provide informed consent.
▪ Absolute contra-indications to exercise as per international clinical guidelines [22, 23].|
▪ PH-related complications, or comorbidities severe enough to prevent attendance at a SPHERe centre, or participation in exercise rehabilitation.
▪ Any mental health issue that will prevent engagement with trial procedures.
▪ Previous randomisation in the present trial
▪ Pregnant at time of recruitment