A commentary notes that as recommended by current GOLD guidelines, long-acting bronchodilators (β2 agonists/muscarinic antagonists) remain first choice of treatment for patients with COPD GOLD B, irrespective of presence or absence of concomitant cardiovascular disease. It adds that thanks to the SUMMIT study, this strong recommendation is now based on a high level of evidence. Furthermore, as observational studies suggest that treatment of patients with COPD with cardiovascular drugs (e.g. β blockers) given beyond the established indications might reduce mortality, this should be assessed appropriately in future large RCTs.