No therapy for idiopathic pulmonary fibrosis (IPF) has been proven to improve mortality or quality of life. However, like many diseases for which we now have cures, disease pathogenesis needed to be understood first before we could develop effective medications. Most of us have thought for a long time that pulmonary hypertension (PH) is a very bad marker of IPF severity. In this issue of CHEST (see page 2393), Nadrous et al1 report on the outcome of a large cohort of patients at the Mayo Clinic showing that PH has a significant correlation with mortality due to IPF. While not surprising, there is certainly a more positive spin to these data that needs to be explored.