Nakayama S, Chubachi S, Sakurai K, et al. - Researchers undertook this observational analysis to determine the association between clinical features of COPD patients with pulmonary hypertension (PH) identified by echocardiography and several outcome parameters such as COPD exacerbation and health status over a three-year observation span. For PH, a prevalence of 21.9% (40 patients) was reported. Older age, a lower body mass index, worse score in the COPD Assessment Test and St. George’s Respiratory Questionnaire, and a lower diffusing capacity of the lung for carbon monoxide were noted among COPD patients with PH vs patients without PH. Computed tomography images of COPD patients with PH vs those without PH revealed higher percentages of low-attenuation areas (LAA%) and interstitial abnormalities. Higher values for LAA% (LAA ≥ 30%) and interstitial abnormalities independently raised PH risk. As per follow-up findings, patients with PH vs those without PH experienced a significantly higher frequency of exacerbations in three years. Findings revealed that the presence of PH evaluated by echocardiography was associated with future COPD exacerbations and closely connected to radiographical emphysema.