It has been demonstrated that COPD is associated with excess cardiovascular disease even after controlling for potential confounders, such as tobacco exposure.3,5 These studies, however, are not able to account for treatment differences, which could significantly affect the observed associations. The study by Enriquez et al1 has implications applicable both clinically and for future research design. Clinically, physicians should work to challenge the misperception that β-blockers are contraindicated in COPD. Data clearly show that cardioselective β-blockers are well tolerated in COPD5,6 and should not be withheld for this reason. The disparity of statin prescription is somewhat perplexing and perhaps explained by the observation of favorable lipid profiles, which may be associated with COPD.7 In terms of future research design, it is clearly imperative that studies of CAD in COPD take into consideration the possible confounding effect of potentially inadequate cardioprotective regimens given to these patients.