Chronic obstructive pulmonary disease (COPD) is the only chronic disease whose prevalence is increasing. It is the third cause of death wordwide, and it is projected to became the third in about ten years. COPD is strongly associated with cardiovascular diseases: this association is in part explained by risk factors in common (especially smoking), but in the latest years the hypothesis that COPD may cause a systemic inflammatory state, that in turn causes the increased risk of cardiovascular diseases in these patients, is taking over. The aim of this paper is to review the available evidence about the association of COPD with systemic inflammation, and how this is linked with development of cardiovascular diseases.