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Pulmonary hypertension (PH) is a disease with poor prognosis, and it is characterized by the progressive elevation of pulmonary vascular resistance and pressure. Various factors are associated with the pathology of PH, including AMP‑activated protein kinase (AMPK) deficiency. The present study aimed to evaluate the therapeutic effect of metformin, an AMPK activator, in a monocrotaline (MCT)‑induced PH rat model. Rats were randomly divided into the following three groups: i) Saline‑injected group (sham group); ii) monocrotaline (MCT)‑injected group (PH group); iii) MCT‑injected and metformin‑treated group (MT group). Four weeks following MCT injection, cardiac ultrasonography, invasive hemodynamic measurements, measurement of serum levels of big endothelin‑1 (big ET‑1) and histological analysis were performed to evaluate the effect of metformin treatment in PH. Pulmonary arterial pressure and …