Adult Asthma and Risk of Coronary Heart Disease, Cerebrovascular Disease, and Heart Failure: A Prospective Study of 2 Matched Cohorts
Open Access
- 8 November 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Epidemiology
- Vol. 176 (11), 1014-1024
- https://doi.org/10.1093/aje/kws181
Abstract
Asthma has been associated with increased cardiovascular disease (CVD) risk. The authors ascertained the association of asthma with CVD and the roles that sex, concurrent allergy, and asthma medications may play in this association. They assembled a cohort of 203,595 Northern California adults with asthma and a parallel asthma-free referent cohort (matched 1:1 on age, sex, and race/ethnicity); both cohorts were followed for incident nonfatal or fatal CVD and all-cause mortality from January 1, 1996, through December 31, 2008. Each cohort was 66% female and 47% white. After adjustment for age, sex, race/ethnicity, cardiac risk factors, and comorbid allergy, asthma was associated with a 1.40-fold (95% confidence interval (CI): 1.35, 1.45) increased hazard of coronary heart disease, a 1.20-fold (95% CI: 1.15, 1.25) hazard of cerebrovascular disease, a 2.14-fold (95% CI: 2.06, 2.22) hazard of heart failure, and a 3.28-fold (95% CI: 3.15, 3.41) hazard of all-cause mortality. Stronger associations were noted among women. Comorbid allergy predicted CVD but did not synergistically increase the CVD risk associated with asthma. Only asthma patients using asthma medications (particularly those on oral corticosteroids alone or in combination) were at enhanced risk of CVD. In conclusion, asthma was prospectively associated with increased risk of major CVD. Modifying effects were noted for sex and asthma medication use but not for comorbid allergy.Keywords
This publication has 52 references indexed in Scilit:
- Asthma Prevalence Associated with Geographical Latitude and Regional Insolation in the United States of America and AustraliaPLOS ONE, 2011
- Asthma, chronic obstructive pulmonary disease, and type 2 diabetes in the Women's Health StudyDiabetes Research and Clinical Practice, 2010
- Decreased serum vitamin D levels in children with asthma are associated with increased corticosteroid useJournal of Allergy and Clinical Immunology, 2010
- Vitamin D Levels, Lung Function, and Steroid Response in Adult AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2010
- Racial Differences in Incident Heart Failure among Young AdultsNew England Journal of Medicine, 2009
- Nonclassic Actions of Vitamin DJournal of Clinical Endocrinology & Metabolism, 2009
- Relation of Adult-Onset Asthma to Coronary Heart Disease and StrokeThe American Journal of Cardiology, 2008
- Vitamin D Deficiency and Risk of Cardiovascular DiseaseCirculation, 2008
- Endothelin-1 in exhaled breath condensate of allergic asthma patients with exercise-induced bronchoconstrictionRespiratory Research, 2007
- Adult-onset asthma is associated with increased carotid atherosclerosis among women in the atherosclerosis risk in communities (ARIC) studyAtherosclerosis, 2006