The present invention is generally related to methods and systems for preventing onset or worsening of RHF in patients with implanted ventricular assist devices. More particularly, the present invention relates to identifying patients at risk for RHF following implantation of a ventricular assist device based on pulmonary artery pressure measurement and/or trends and adjusting a pump operating parameter to prevent or reduce the onset or worsening of RHF in such patients, improve patient outcomes, or reduce mortality risks associated with VAD implantation. In particular, a pump operating parameter may be adjusted to reduce or minimize particularly high pressure loads on a patient's heart or amount of time the patient is exposed to such high pressure loads following implantation.