Chronic obstructive pulmonary disease (COPD) is a major health problem worldwide. It is characterized as a chronic inflammatory lung disease that causes obstructed airflow from the lungs. It is typically caused by long-term exposure to cigarette smoke, but household air pollution, ambient particulate matter, ozone, and occupational particulates, including coal dust, also contribute to COPD. According to the Global Burden of Disease, 544.9 million people worldwide had a chronic respiratory disease in 2017, which represents an increase of 39.8% compared with 1990. Among the respiratory diseases, COPD remained the most prevalent disease-specific condition in 2017, accounting for 55.1% of chronic respiratory disease prevalence among men and 54.8% among women globally. More importantly, most chronic respiratory disease-attributable deaths and disability-adjusted life years were due to COPD.

Consistent evidence has indicated that COPD is associated with increased cardiovascular risk, which is an important cause of death in COPD patients.^, Systemic inflammation, chronic hypoxia, sympathetic activation, lung hyperinflation, secondary erythrocytosis, and loss of pulmonary vascular surface are responsible for increasing the rate of conditions such as pulmonary hypertension, right ventricular dysfunction, arrhythmias, ischemic coronary disease, among others. More recently, the association between COPD and hypertension has gained increasing attention. In a Danish cohort of more than 70,000 COPD patients, 47.6% of the patients had hypertension (the most common comorbidity in these patients). Although it is not clear whether COPD increases the incidence of hypertension, uncontrolled blood pressure (BP) is associated with poor prognosis in patients with COPD. These findings pave the way for additional characterization of the impact of COPD on BP variability.

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