Recently there has been observed  a change in the way of perceiving the pathogenesis and range of the chronic obstructive pulmonary  disease. The GOLD 2008 rapport is a factor that has significantly influenced this change. It is now known that the chronic obstructive pulmonary  disease is not only bronchi or lung disability. Enhancing amount of data, obtained from research indicates that disease may have a systemic nature, causing many comorbidities, among them metabolic syndrome, diabetes, cardiovascular disease, kidney disorders, osteoporosis, skeletal muscles dysfunction together with nutritional status disorders, anemia, testosterone deficiency syndrome and mental disorders.

The low-grade systemic inflammation seems to be the common pathogenetic basis of the diseases mentioned above. There are factors that indicate existence of general inflammation, such as  increased level of proinflammatory cytokines IL -1, IL- 6, TNF-α and high sensitive c-reactive protein. The comorbidities influence the clinical course prognosis of the disease. This multidimensional character of the chronic obstructive pulmonary  disease compels doctors into holistic treatment and applying medicines effective for comorbidities and reduce consequences of systemic inflammation.