Hypoxic pulmonary hypertension (HPH) is often caused by lung diseases such as chronic obstructive pulmonary disease, which ultimately leads to pulmonary heart disease. It is currently believed that hypoxic pulmonary vasoconstriction (HPV) and pulmonary vascular remodeling (PVR) are two main stages of HPH whereas PVR is the main cause of ineffective vasodilators. PVR was thought to be caused by an inflammatory response, but nowadays it was considered as the common results of multiple factors. This review focuses on the role of cytokines, oxidative stress, intracellular and extracellular ions, autophagy and apoptosis in the HPH process. We introduces the current research achievements on HPH treatment, and proposes conjectures for future research directions. As an irreversible lethal disease, pulmonary arterial hypertension (PAH) has been a hot topic in current lung transplantation research, but there are many types of PAH while different types of PAH formation mechanisms are different. This review summarized the progress in mechanism of PVR and corresponding treatments.