Matsushita K, et al. - In patients with acute heart failure (HF), the link between high estimated pulmonary artery systolic pressure (ePASP) obtained by echocardiography and 1-year mortality was investigated. In addition, the findings in individuals aged 80 and older were compared with those younger than 80. They defined high ePASP as a tricuspid regurgitation pressure gradient higher than 47 mmHg (ePASP >50 mmHg). On analyzing individuals with acute decompensated HF (N = 335), they observed high ePASP, discharge medications without diuretics, and discharge medications without renin–angiotensin–aldosterone system inhibitors as independent risk factors for 1-year mortality in individuals aged 80 and older. Low systolic blood pressure at admission was the only independent risk factor for 1-year mortality in those younger than 80. In patients aged 80 and older with acute HF, but not those younger than 80, high ePASP significantly predicts 1-year mortality.