© 2015 Elsevier Inc. All rights reserved. Background Chronic obstructive pulmonary disease (COPD) is a frequent comorbidity in patients with heart failure (HF). Elevated pulmonary arterial (PA) pressure can be seen in both conditions and has been shown to predict morbidity and mortality. Methods and Results A total of 550 subjects with New York Heart Association functional class III HF were randomly assigned to the treatment (n = 270) and control (n = 280) groups in the CHAMPION Trial. Physicians had access to the PA pressure measurements in the treatment group only, in which HF therapy was used to lower the elevated pressures. HF and respiratory hospitalizations were compared in both groups. A total of 187 subjects met criteria for classification into the COPD subgroup. In the entire cohort, the treatment group had a 37% reduction in HF hospitalization rates (P <.0001) and a 49% reduction in respiratory hospitalization rates (P =.0061). In the COPD subgroup, the treatment group had a 41% reduction in HF hospitalization rates (P =.0009) and a 62% reduction in respiratory hospitalization rates (P =.0023). The rate of respiratory hospitalizations in subjects without COPD was not statistically different (P =.76). Conclusions HF management incorporating hemodynamic information from an implantable PA pressure monitor significantly reduces HF and respiratory hospitalizations in HF subjects with comorbid COPD compared with standard care.