A cohort study with more than a decade of follow-up revealed that late-onset asthma was associated with an increased risk for stroke and cardiovascular events. Participants in the Wisconsin Sleep Cohort diagnosed with asthma as adults were 57% more likely to experience a cardiovascular event during 14 years of follow-up than participants without asthma, reports Medpage Today. There was no difference seen in cardiovascular disease (CVD) risk between non-asthmatics and those with early-onset asthma, according to Matthew Tattersall, DO, and colleagues.
The analysis included 1,269 Wisconsin Sleep Cohort participants without CVD at study entry, including 111 with late-onset and 55 with early-onset asthma. Compared with the 1,103 study participants without asthma, individuals with late-onset asthma were more likely to be female, had a higher body mass, and were more likely to be taking antihypertensive medications. A total of 223 CVD events occurred during follow-up, including 179 in the non-asthma group, 22 in the late-onset asthma group, and seven in the early-onset asthma group.
The authors reported that the 10-year CVD-event rates were 12.7% among participants with late-onset asthma, 3.8% among those with early-onset asthma, and 8.9% among non-asthmatics. Medpage Today reports that in multivariate models fully adjusted for potential confounders, late-onset asthmatics had a higher risk for CVD events than non-asthmatics; however, those with early-onset asthma showed no difference in CVD events compared to non-asthmatics in models adjusted for age and sex and in fully adjusted models.
According to Medpage Today, the analysis is among the first to explore the impact of asthma on CVD risk by asthma phenotype. The authors note that late-onset asthma tends to be more severe and more refractory to medical treatments than the early-onset asthma, and these differences may help explain the study’s findings. The researchers write, “Late-onset asthma has myriad different risk factors including environmental irritants, obesity, female sex hormones, respiratory infections, stressful life events, and aspirin use.”
While previous studies have hypothesized that the increased risk of CVD in women with late-onset asthma may be due to estrogen-modulated inflammation, the researchers concluded that while this may be true for certain late-onset asthma phenotypes often seen in women, it does not appear to explain the increased CVD risk for all phenotypes. The researchers note that eosinophils may also play a role in the increased risk of CVD.
“Given the public health burden of asthma, further investigations into the mechanisms of this association in speci?c asthma phenotypes are needed,” according to the researchers.
Source: Medpage Today