Pulmonary hypertension is a clinical syndrome characterized by a progressive increase in pulmonary vascular resistance due to structural or functional changes in the pulmonary vascular bed caused by various reasons, which eventually leads to right ventricular dilatation, right heart failure and even death. Currently, the main treatments for pulmonary hypertension are general therapy, supportive therapy, targeted drug therapy, and other treatments such as lung transplantation can be considered for end-stage patients. In recent years, targeted drug therapy for pulmonary hypertension has developed rapidly, such as calcium antagonists, prostacyclin analogs, endothelin receptor antagonists, type 5 phosphodiesterase inhibitors and other novel agents have been widely used in patients with pulmonary hypertension, and also achieved better efficacy. However, some patients still experience a decrease in exercise tolerance, quality of life and survival while being treated with targeted drugs, which requires us to further improve the treatment of patients with pulmonary hypertension and explore appropriate adjuvant therapies to further improve the prognosis of patients with pulmonary hypertension. Perhaps we can gain some insight from the widely used clinical cardiopulmonary exercise test. The cardiopulmonary exercise test (CPET) is a non-invasive kinetic test that provides a comprehensive and simultaneous assessment of the cardiovascular system, the whistling system, the hematopoietic system, the neurological and skeletal muscle systems involved in exercise. It has a good value in assessing the functional reserve, disease severity and lesion progression of patients. The value of the cardiopulmonary exercise test in clinical practice is mainly related to the assessment of the degree of limitation of exercise tolerance; the evaluation of disease prognosis and the function of various systems through the measurement of exercise tolerance and related parameters; and the assessment of disease progression and the patient’s response to treatment. Cardiopulmonary exercise testing is considered the gold standard for assessing the degree of exercise tolerance limitation and related mechanisms in patients. The degree of exercise tolerance limitation in many patients with chronic cardiopulmonary disease is often not measured by resting state tests, which demonstrates the superiority of cardiopulmonary exercise testing in assessing exercise tolerance in patients. The results of the cardiopulmonary exercise test in patients with pulmonary hypertension show that patients have impaired ventilation, gas exchange, and varying degrees of cardiac function; all of which ultimately lead to a decrease in exercise tolerance in patients with pulmonary hypertension. Decreased exercise tolerance is the main source of clinical symptoms in patients with pulmonary hypertension, with patients complaining of dyspnea and weakness. As a result of increased pulmonary artery pressure, blood flow through the alveoli is reduced, resulting in an imbalance in the ratio of alveolar ventilation to blood flow, which leads to dyspnea; while the reduction in cardiac output causes a lack of systemic oxygen supply and muscle dysfunction, especially in skeletal muscle, where muscle atrophy, contraction disorders, muscle fiber abnormalities, and reduced muscle capillary density occur, resulting in weakness and other symptoms. All of these manifestations in patients with pulmonary hypertension seriously affect their quality of life, which urges clinicians to explore more appropriate adjunctive therapies. Exercise and inspiratory training may be an ideal option for patients with pulmonary hypertension. In the past, this approach was thought to increase the risk of sudden cardiac death, and high-load exercise exacerbated pulmonary vascular remodeling and right heart failure. However, in recent years, the use of targeted drugs for pulmonary hypertension has led to significant improvements in patient prognosis, which warrants reconsideration of the value of exercise and whistle training in patients with pulmonary hypertension. Patients with pulmonary hypertension can benefit greatly from exercise and inspiratory training. Exercise training increases metabolism, increases muscle strength in the extremities and thus improves exercise tolerance, while whistle training increases gas exchange, increases oxygen concentration, decreases whistle frequency and increases tidal volume, thus improving the efficiency of whistling. Exercise and inspiratory training have been used for a long time in patients with left heart lesions and have shown significant benefits. Exercise and inspiration training improves vascular endothelial function in patients with left heart disease, increases endothelial NO synthase activity to reduce vascular oxidative stress, increases skeletal muscle contraction efficiency, and increases muscle capillary density, thereby increasing exercise tolerance and improving quality of life. The use of exercise and whistle training in patients with pulmonary hypertension has also been confirmed by studies in which Mereles D et al. showed that low-load exercise and whistle training significantly improved exercise tolerance, 6-minute walk test, quality of life, WHO cardiac function class and maximal oxygen consumption in patients with pulmonary hypertension in a subgroup of 30 patients enrolled in a study. This makes exercise and inspiratory training promising as a safe and effective adjunctive therapy for patients with progressive pulmonary hypertension. Studies have also shown that exercise training can also improve exercise tolerance and quadriceps function, and support exercise training as an adjunctive therapy for patients with stable idiopathic pulmonary hypertension. Patients with pulmonary hypertension can benefit greatly from exercise training, but the safety of its use is also of concern. The safety and reliability of exercise training has been demonstrated in studies; patients who participated in exercise and inspiratory training tolerated it well without any adverse effects such as exacerbation of symptoms, progression of pulmonary hypertension, or right heart failure. However, the safety of patients with pulmonary hypertension with right heart failure or those who performed high-load exercise and inspiratory training on their own without the guidance of a physician was poor. The improvement in long-term survival of patients with pulmonary hypertension has also been demonstrated with exercise and whistle training. A prospective clinical trial showed that exercise and inspiratory training as an adjunctive therapy for patients with pulmonary hypertension can increase exercise tolerance, improve quality of life, and have a reliable long-term safety profile. In conclusion, patients with pulmonary hypertension can benefit from exercise and inspiratory training, which further improves the effectiveness of modern treatment for patients with pulmonary hypertension and becomes an effective adjunct to targeted therapy; exercise and inspiratory training is safe and can be performed under professional medical guidance for greater benefit; and it is economical and practical, reducing the economic and psychological burden of patients and having a good social effect.