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Introduction Cardiac power output (CPO) is a haemodynamic metric that integrates components of left and right heart function. Recent data demonstrated its utility in predicting outcomes in cardiogenic shock and we sought to assess whether resting CPO is a useful predictor of mortality in pulmonary hypertension (PH) patients.Methods Consecutive patients from the Sheffield ASPIRE registry referred for investigation of suspected PH between 2011 and 2024 were included. All patients underwent comprehensive baseline assessment including right heart catheterisation. CPO was calculated as (mean systemic arterial pressure - right atrial pressure)*cardiac output/451. Prognostic performance was assessed using univariable and multivariable Cox regression and receiver operating characteristic analysis. Patients who did not have PH were included for descriptive comparisons but not in survival models and patients with incomplete data were excluded.Results 2420 patients were included (mean age 65±14; 59% female). 571 = Pulmonary Arterial Hypertension, 490 = PH-Left Heart Disease, 446 = PH-Lung Disease, 572 = Chronic Thromboembolic PH, 66 = PH Unclear/Multifactorial, 280 did not have PH. Median CPO was 0.92W in PH patients, with lower CPO in all diagnostic groups compared to patients without PH (median CPO 1.20W; Kruskal–Wallis p< 0.001).In univariable analysis, higher CPO was associated with improved overall and 1 year survival (HR per 0.20W for 1-year mortality = 0.888, 95% CI: 0.863-0.915, p<0.001 ; n=2145). In multivariable analysis, CPO remained an independent predictor of both overall and 1-year mortality after adjusting for age, sex, diagnosis, BSA and WHO-functional class (HR per 0.20W for 1-year mortality = 0.819, 95% CI: 0.758-0.885, p<0.001; n=2145). An adjusted CPO-based model demonstrated superior discrimination to a cardiac index–based model and comparable performance to right atrial pressure (RAP)- and mixed venous oxygen saturation (SvO2)-based models (1-year mortality AUC for CPO = 0.730; n=2145).Conclusion Cardiac power output is a strong predictor of both overall and 1-year mortality across the pulmonary hypertension spectrum. CPO offers discrimination comparable to established ERS/ESC haemodynamic risk predictors including cardiac index, RAP and SvO 2, supporting its potential role in PH risk stratification.