Asthma and incident cardiovascular disease: the Atherosclerosis Risk in Communities Study

Background: A possible association between asthma and cardiovascular disease has been described in several exploratory studies. Methods: The association of self-reported, doctor diagnosed asthma and incident cardiovascular disease was examined in a biracial cohort of 45–64 year old adults (N = 13501...

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Published in:	Thorax Vol. 60; no. 8; pp. 633 - 638
Main Authors:	Schanen, J G, Iribarren, C, Shahar, E, Punjabi, N M, Rich, S S, Sorlie, P D, Folsom, A R
Format:	Journal Article
Language:	English
Published:	London BMJ Publishing Group Ltd and British Thoracic Society 01-08-2005 BMJ BMJ Publishing Group LTD BMJ Group
Subjects:	Airway management Angina pectoris Arteriosclerosis - etiology Asthma Asthma - complications Asthma - physiopathology Atherosclerosis Atherosclerosis (general aspects, experimental research) Biological and medical sciences Blood and lymphatic vessels Bronchitis Cardiology. Vascular system Cardiovascular disease Cerebrovascular disease CHD Cholesterol Chronic obstructive pulmonary disease, asthma Coronary Artery Disease - etiology coronary heart disease CVD Diabetes Electrocardiography Female FEV1 Forced Expiratory Volume - physiology forced expiratory volume in 1 second forced vital capacity FVC Glucose hazards ratio Heart attacks High density lipoprotein Hospitals Humans Male Medical sciences Middle Aged Mortality Pneumology Population Proportional Hazards Models Questionnaires Risk Factors risk ratio Self report Smoking SMR standardised mortality ratio Stroke Stroke - etiology Surveillance Vital Capacity - physiology Womens health Vascular disease Lung disease Respiratory disease Atherosclerosis Risk factor Cardiovascular risk Bronchus disease Cardiovascular disease Obstructive pulmonary disease Community Asthma
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Summary:	Background: A possible association between asthma and cardiovascular disease has been described in several exploratory studies. Methods: The association of self-reported, doctor diagnosed asthma and incident cardiovascular disease was examined in a biracial cohort of 45–64 year old adults (N = 13501) followed over 14 years. Results: Compared with never having asthma, the multivariate adjusted hazard ratio (HR) of stroke (n = 438) was 1.50 (95% CI 1.04 to 2.15) for a baseline report of ever having asthma (prevalence 5.2%) and 1.55 (95% CI 0.95 to 2.52) for current asthma (prevalence 2.7%). The relative risk of stroke was 1.43 (95% CI 1.03 to 1.98) using a time dependent analysis incorporating follow up reports of asthma. Participants reporting wheeze attacks with shortness of breath also had greater risk for stroke (HR = 1.56, 95% CI 1.18 to 2.06) than participants without these symptoms. The multivariate adjusted relative risk of coronary heart disease (n = 1349) was 0.87 (95% CI 0.66 to 1.14) for ever having asthma, 0.69 (95% CI 0.46 to 1.05) for current asthma at baseline, and 0.88 (95% CI 0.69 to 1.11) using the time dependent analysis. Conclusions: Asthma may be an independent risk factor for incident stroke but not coronary heart disease in middle aged adults. This finding warrants replication and may motivate a search for possible mechanisms that link asthma and stroke.
Bibliography:	local:0600633 istex:04ECCAE2DF6691AA13DA4D71DA508D455620197C PMID:16061703 Correspondence to:  Dr A R Folsom  University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA; folsom@epi.umn.edu href:thoraxjnl-60-633.pdf ark:/67375/NVC-Q2TJ53R0-M ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0040-6376 1468-3296
DOI:	10.1136/thx.2004.026484