Pulmonary arterial hypertension (PAH) has remained a challenging disease with poor survival [1]. Accurate risk stratification in PAH is crucial for making treatment decisions and prognostication. Current European guidelines recommend routine risk assessment at baseline and follow-up evaluation [2]. Due to the complex nature of the disease and many factors influencing survival in PAH, it is recommended to have a multiparametric risk assessment in PAH [2–5]. Over the years, individual risk stratification tools have undergone refinements. For example, the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL) primary risk calculator evolved over the years from REVEAL 1.0 to REVEAL 2.0 and REVEAL lite 2 in order to incorporate new variables and realign older variables for improved versatility and applicability [3, 4, 6]. Thus, the purpose of evolving risk assessment tools is to improve their accuracy in predicting mortality and morbidity while keeping their ease of use in routine clinical practice. Since treatment strategy is intimately intertwined with the risk status of a patient, it is imperative to perform routine risk assessment with as much accuracy and precision as possible to prevent over- or underestimation of risk, so patients are assigned the most efficacious upfront therapy.

肺动脉高压（PAH）仍然是一种具有挑战性的疾病，生存率低[1]。 PAH 的准确风险分层对于制定治疗决策和预测至关重要。目前的欧洲指南建议在基线和后续评估中进行常规风险评估[2]。由于PAH疾病的复杂性和影响PAH生存的因素较多，建议对PAH进行多参数风险评估[2-5]。多年来，个人风险分层工具已经过完善。例如，评估早期和长期 PAH 疾病管理登记处 (REVEAL) 主要风险计算器多年来从 REVEAL 1.0 发展到 REVEAL 2.0 和 REVEAL lite 2，以便纳入新变量并重新调整旧变量，以提高多功能性和适用性[3,4,6]。因此，不断发展风险评估工具的目的是提高其预测死亡率和发病率的准确性，同时保持其在常规临床实践中的易用性。由于治疗策略与患者的风险状态密切相关，因此必须尽可能准确和精确地进行常规风险评估，以防止高估或低估风险，因此为患者分配最有效的前期治疗。