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·Chronic obstructive pulmonary disease (COPD) is defined as a preventable and treatable disease with significant extrapulmonary effects, which may contribute to the disease severity in individual patients. ·An increasing amount of attention has been paid to causal relationships between one disorder and another and to an underlying vulnerability to different disorders. ·A patient-oriented approach to COPD needs to take into account that several coexisting components of the chronic disease can contribute to the experienced symptomatology. [ABSTRACT FROM AUTHOR]