Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 176, Issue 11, Pages 1014-1024Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kws181
Keywords
asthma; cardiovascular diseases; cohort studies; coronary disease; heart failure
Categories
Funding
- Genentech, Inc. (South San Francisco, California)
- Genentech, Inc.
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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.
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