Hypertension in Chronic Obstructive Pulmonary Disease. Reply.

To the Editor: Finks and colleagues (Jan. 23 issue)(1) lend clarity to the management of hypertension in chronic obstructive pulmonary disease (COPD). In the era of costly drug development and health care, their review needs to be seen in the context of the bigger therapeutic picture of COPD and cardiovascular disease, particularly the comorbidity-driven phenotype of heart failure with preserved ejection fraction.(2) In a retrospective assessment of roflumilast, the only phosphodiesterase-4 inhibitor indicated to reduce the risk of exacerbations in severe COPD, the authors reported a lower risk of cardiovascular events.(3) Multifaceted targeting of inflammatory pathways holds the promise of . . .