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Background CTEPH can be treated by mechanical therapy with PEA and/or BPA. The haemodynamic treatment goal is ill defined. We explored post-procedure mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), and 5-year survival and QoL differences using 6MWD and CAMPHOR symptoms score for mPAP.Method 1,752 PEA and 172 BPA patients from the UK national database were stratified into 5 groups by 3-month follow-up mPAP and PVR to generate Kaplan-Meier curves with Kruskal-Wallis and pairwise log-rank tests. Cox proportional hazards models assessed survival differences, adjusted for age, sex and comorbidities. We similarly assessed 6MWD and CAMPHOR scores to examine QoL.Results After PEA, 5-year survival was significantly higher in patients with mPAP ≤25 mmHg compared to higher groups (all pairwise comparisons p < 0.002); there was no additional survival advantage between ≤20 and 21–25 mmHg. A continuous PVR model showed a 0.16% increase in mortality risk per 1 dyn·s·cm − 5 increase (p = 2.1e-10; concordance = 0.699). Adjusting for hazards with a Cox model, results remained significant. QoL measurements showed a similar trend (p = 2.2e-16 for the 6MWD).In the BPA cohort, 5-year survival was significantly higher when mPAP ≤30 mmHg was achieved. A continuous PVR model variable showed a 0.34% increase in mortality risk per unit increase (p = 0.002; concordance = 0.70). For QoL we saw no significant difference between mPAP groups.Conclusions Post-procedure haemodynamics predict 5-year survival and QoL in PEA patients, with mPAP ≤30 mmHg and ≤25 mmHg conferring the best prognosis for BPA and PEA-treated patients, respectively. These data should encourage therapy escalation in those not achieving mPAP thresholds.