Many patients at high cardiovascular (CV) risk suffer from chronic obstructive pulmonary disease (COPD). We hypothesize that the diagnosis and adequate treatment of COPD may be associated to a better tissue oxygenation, lessen systemic inflammation and, thus, improve endothelial function. We intend to assess the variations of endothelial function, after optimizing COPD therapy, in high and very high CV risk patients. To our knowledge no previous studies have explored this hypothesis. The main challenge is to perform accurate measures of endothelial function by a reproducible method that allows to detect changes after optimizing bronchodilator therapy. Cardiovascular Suite-FMD Studio is the device used for this study, in order to detect and quantify changes in vascular endothelium function by measuring flow mediated-dilation (FMD) of brachial artery.