MRCP2-4388

A 65-year-old woman presents to the Respiratory Clinic for evaluation. She has recently been diagnosed with moderate COPD and is preparing to start treatment for the condition. Additionally, she has a medical history of hypertension and chronic stable angina, for which she takes ramipril, indapamide, and diltiazem. During the examination, her blood pressure is 132/82 mmHg, with a pulse of 70/min and regular rhythm. Upon auscultation of the chest, there is bilateral poor air entry with quiet wheezing. What is the most significant factor that will impact her quality of life in the next 2-3 months?