Is Asthma a Risk Factor for CVD?

Chronic systemic inflammation is known to play a role in poor asthma control as well as atherosclerotic or ischemic disease. Research has suggested that asthma may be a risk factor for cardiovascular disease (CVD), but there is not enough strong evidence to conclusively support this claim. A better understanding of this relationship may lead to risk management strategies for patients with asthma to better reduce their CVD risk. A study used Framingham Offspring Cohort data to longitudinally assess the relationship between asthma and lifetime CVD risk, controlling for other CVD risk factors. The results were published online as part of the ATS 2020 International Conference.
Data on 3,612 patients aged 17 to 77 years were evaluated. Patients had participated in Framingham Offspring Study examinations from 1979 to 2014. Asthma was defined as a physician diagnosis made during study interviews, and CVD encompassed myocardial infarction, angina, coronary insufficiency, stroke, transient ischemic attack, and heart failure. The researchers estimated the unadjusted likelihood of CVD incidence among patients with and without asthma using the Kaplan Meier method and then made comparisons with the log-rank test. The adjusted relationship between asthma and CVD incidence was assessed with time-dependent Cox regression models.
Among the total cohort, 534 patients (10%) were diagnosed with asthma, and 897 (25%) developed CVD. In unadjusted analyses, asthma was correlated with an increased risk for CVD incidence (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.17-1.68). In Cox regression models, when controlling for established cardiovascular risk factors, asthma was also an independent risk factor for CVD incidence (HR, 1.28; 95% CI, 1.07-1.54).
“Using data from a large population-based cohort, we found that asthma is associated with a higher risk of CVD after carefully adjusting for other cardiovascular risk factors. Our study identifies [patients with] asthma as a high-risk group that may benefit from targeted interventions to prevent onset of CVD and suggest a potential role for the need for personalized CVD prevention strategies among patients with asthma,” the study authors summarized. They called for future studies to evaluate the pathophysiology of systemic inflammation underlying asthma and CVD.