Persistent asthma associated with cardiovascular risk factors

Recent research suggests that adults with asthma may be at increased risk of heart attacks and strokes due to excessive accumulation of plague in their carotid arteries. Participants with persistent asthma also had higher levels of inflammatory biomarkers compared with those without asthma or those with intermittent asthma.

Analysis presented in Journal of American Heart AssociationExcessive accumulation of plaque in the carotid artery was present in 67% of study participants with persistent asthma, a significantly higher proportion than participants without asthma (50.5%) or participants with intermittent asthma (49.5%) is.

“Many physicians and patients are unaware that asthmatic airway inflammation can affect the arteries, so for those with persistent asthma, addressing cardiovascular disease risk factors is very difficult. It could be helpful,” said lead study author Matthew C. Tattersall.Assistant Professor of Medicine, University of Wisconsin-Madison in the news release.

Data used for this analysis are from participants enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA). Participants were recruited between He 2000 and He 2002 from a research center located in Baltimore. Chicago; Los Angeles County; New York City; Forsyth County, North Carolina. and St. Paul, Minnesota. All participants were free of cardiovascular disease at enrollment. Studies following these participants are ongoing.

From the MESA data, 5029 adults were included in this analysis. These participants had baseline data on cardiovascular disease risk factors and carotid ultrasound data.

Participants were ethnically and racially diverse, identifying themselves as 26% of adults African American, 23% Hispanic, and 12% Chinese. Additionally, 53% of the group were female.

Participants were divided into subgroups consisting of persistent asthma patients (n = 109), defined as using medication daily to control their asthma symptoms. Patients with intermittent asthma (n = 388), defined as having a history of asthma but not using daily medications. People without asthma (n = 4532).

Investigators used carotid ultrasonography to determine the presence or absence of plaque on both the left and right walls of the carotid artery using a total plaque score (TPS), which indicates the number of segments with carotid plaque on a scale of 0-12. defined the load. The inflammatory biomarkers IL-6 and C-reactive protein (CRP) were also recorded.

The authors found that carotid plaques were present in about half of participants without asthma or with intermittent asthma, whereas about two-thirds of participants with persistent asthma (50.5%, respectively) had carotid plaques. 49.5%, and 67.0%). Patients with persistent asthma had the highest mean (SD) TPS of 2.08 (2.35) compared to 1.29 (1.80) in those without asthma and 1.25 (1.76) in those with intermittent asthma (P. < .003).

After adjusting for age, sex, race, weight, and other factors such as taking prescription drugs or smoking, participants with persistent asthma were nearly as likely to have carotid plaque in the carotid artery of participants without asthma. 2-fold higher (odds ratio 1.83; 95% CI, 1.21–2.76; P < .001).

When researchers accounted for IL-6 and CRP, the link between persistent asthma and carotid plaque remained.

“Participants with persistent asthma had increased levels of inflammation in their blood even though their asthma was being treated with medication, highlighting the inflammatory signature of asthma.” We know that inflammation has a negative impact on the cardiovascular system,” Tattersall said.

However, because this study is an observational analysis, the findings only show an association between asthma and cardiovascular disease, not cause and effect.

“The most important message from our findings is that more severe forms of asthma are associated with more cardiovascular disease and events,” said Tattersall.

reference

Tattersall MC, Dasiewicz AS, McClelland RL, et al. Persistent asthma is associated with carotid plaque in MESA. J Am Hart Associate2022;11:e026644.doi:10.1161/jaha.122.026644