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Pathologic changes in chronic obstructive pulmonary disease (COPD) occur in the large (central) airways, the small (peripheral) bronchioles, and the lung parenchyma. Most cases of COPD are the result of exposure to noxious stimuli, most often cigarette smoke.
Chronic obstructive pulmonary disease (COPD) affects various domains of lung structure and function, leading to airflow limitation (1). Besides these pulmonary abnormalities, COPD is also associated with significant effects in distant organs outside the lungs, the so-called systemic effects of COPD (2, 3). This article reviews the types, mechanisms, and clinical implications of these systemic effects.