期刊
LUNG
卷 192, 期 5, 页码 675-683出版社
SPRINGER
DOI: 10.1007/s00408-014-9600-y
关键词
Asthma; Airway obstruction; Hypertension; Lung; Sleep apnea; Obstructive
资金
- University of Michigan General Clinical Research Center [MO1 RR00042]
- Neurology Department Training Grant [5T32NS007222]
- University of Wisconsin School of Medicine and Public Health, Department of Medicine, and Medical Education and Research Committee - New Investigator Award
- Clinical and Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health [1UL1RR025011]
Asthmatics have unique characteristics that may influence cardiovascular morbidity. We tested the association of lower airway caliber, obstructive sleep apnea (OSA), and other asthma-related factors, with systemic hypertension (HTN). Asthma individuals at specialty clinics completed the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ). Medical records were reviewed for diagnosed HTN, OSA and comorbidities, spirometry, and current medications. FEV1% predicted was categorized as a parts per thousand yen80 (reference), 70-79, 60-69, and < 60. SA-SDQ a parts per thousand yen36 for men and a parts per thousand yen32 for women defined high OSA risk. Among 812 asthmatics (mean age +/- A standard deviation: 46 +/- A 14 years), HTN was diagnosed in 191 (24 %), OSA in 65 (8 %), and OSA or high OSA risk (combined OSA variable) in 239 (29 %). HTN was more prevalent in lower FEV1% categories (p < 0.0001), in subjects with OSA, and those with combined OSA variable (55 vs. 21 % and 46 vs. 14 %, respectively, both p < 0.0001). With adjustment for covariates, associations with HTN remained significant for some FEV1% categories (70-79 % odds ratio = 1.60 [95 % CI 0.90-2.87]; 60-69 % 2.73 [1.28-5.79]; < 60 % 0.96 [0.43-2.14]), and for OSA (2.20 [1.16-4.19]). The combined OSA variable in comparison with OSA alone demonstrated a stronger association with HTN (3.17 [1.99-5.04]) in a reiteration of this model. Inhaled corticosteroids (ICS) at lowest doses, in comparison to no ICS use had an independent protective association with HTN (0.44 [0.22-0.90]). In this young population, worse lower airways obstruction and OSA were associated with HTN. In contrast, lower ICS doses attenuated likelihood for HTN. Adequate control of airway inflammation at appropriate ICS doses, and screening for OSA may reduce the burden of HTN in asthma.
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