Comorbidities are common in chronic obstructive pulmonary disease (COPD). Cardiovascular comorbidity is a leading cause of morbidity and mortality in COPD patients. Low lung function is a risk factor for increased arterial stiffness, a condition that is common in COPD patients, independent of conventional cardiovascular risk factors. Arterial stiffness is an independent risk factor both for all-cause and for cardiovascular mortality, and carotid–femoral pulse wave velocity is the gold standard for the assessment of arterial stiffness. Various mechanisms proposed in the development of arterial stiffness include systemic inflammation, ageing, advanced glycation end products, renin–angiotensin–aldosterone system, increased elastolysis, and vitamin D deficiency. Early detection of arterial stiffness in COPD patients is warranted to detect cardiovascular comorbidity at the subclinical stage, which would help to prevent overt vascular events in the future. We need well-designed studies to see the impact of therapy that targets increased arterial stiffness on future cardiovascular events in COPD. This review discusses the epidemiology, diagnosis, and therapy of increased arterial stiffness in COPD patients.
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