Domenech A, et al. - In this prospective analysis of 127 patients referred for a monographic COPD consultation, researchers assessed the role of COPD exacerbations as a contributor to an increased vascular risk already associated with the disease. Those who experienced two or more moderate exacerbations in the previous year, or were admitted to the hospital were defined as exacerbators. In this study involving 50 patients with exacerbator phenotypes and 57 with non-exacerbator phenotypes, an independent association was observed between the presence of subclinical atherosclerosis and the exacerbator phenotype; more pronounced differences were found in younger patients. Independently of the severity of COPD and global cardiovascular risk, exacerbator phenotype increased the risk of carotid intima-media thickness above the 75th percentile by a factor of almost three. Based on these findings, intensifying control of vascular risk factors in these groups of patients was recommended.