I'll take a 5 port, excellent condition MK5 over a MK10 any day, but for most divers MK10s are a little more practical, for 3 reasons. 1) some MK5 parts are harder to find; while there is a great NOS selection of MK10 parts out there. 2) MK10s all had SS turret retainers, while some MK5s had brass ones. The SS retainers are better; the older brass ones could easily be damaged by severe over torquing. A small group of us led by Zung went in on a reproduction run of SS turret retainers for the MK5, so we all have enough for our lifetimes, but if you buy a MK5 with a brass retainer that's been manhandled, you'll want to look for a replacement. 3) MK10s are much easier to convert to DIN if that's important. In fact, I use MK5s on my single tanks and my MK10s are set up in DIN for my doubles. 3A) in terms of buying, there simply are more great condition MK10s available; I've never bought one that was in bad shape, but I've seen a few fairly knackered-up MK5s on ebay.
DA Aquamaster wrote an excellent post about why he thinks SP went to the MK10 design, which includes one piece of milled brass for the ambient chamber and HP piston channel, as well as the smaller piston. He believes that SP wanted better tolerances on the piston channel, undoubtedly to address the extrusion problem of the HP piston o-ring and improve alignment with the ambient chamber/piston path, and that was more cost effective with the smaller diameter (or something like that). Later, when SP went back to the larger size, there was better machining technology to ensure the alignment with a 2 piece system. Or at least the post was something like that.
I like the MK5s because the lock up is SO stable and lasts forever. My MK10s will start to creep a few PSI after a season or two. I keep waiting for my tribolube-packed MK5 to show some signs of wear, but it's been a few years and the damn thing won't budge from 125 PSI. Like awap, I've dealt with the IP rise at higher tank pressures by experimenting with o-rings, but I've also tried new pistons and really polishing the piston shaft and cleaning the edge, and both of those things have helped significantly. I use them with balanced 2nds so I never notice anything in terms of increased breathing resistance.
The MK10 does have a higher flow rate spec, but I couldn't begin to tell a difference in breathing performance.