Late‐Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort

• 
   Am Heart Assoc. 2016; 5: e003448doi: 10.1161/JAHA.116.003448
• Original Research - Epidemiology

1. Matthew C. Tattersall, DO, MS¹; 
2. Jodi H. Barnet, MS²; 
3. Claudia E. Korcarz, DVM¹;
4. Erika W. Hagen, PhD²; 
5. Paul E. Peppard, PhD²; 
6. James H. Stein, MD, FAHA*,¹

+Author Affiliations

1. ¹Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
2. ²Department of Population Health, University of Wisconsin School of Medicine and Public Health, Madison, WI

Abstract

Background Asthma is a heterogeneous syndrome with different clinical subtypes that is associated with an increased risk for cardiovascular disease (CVD). We hypothesized that the late‐onset subtype of asthma is associated with a higher risk of incident CVD.

Methods and Results Participants from the Wisconsin Sleep Cohort free of CVD at baseline were followed for a mean (SD) of 13.9 (5.9) years for development of CVD (myocardial infarction, angina, stroke, coronary revascularization, heart failure, or CVD death). Late‐onset asthma was defined as physician‐diagnosed asthma at age ≥18 years. Multivariable Cox regression models adjusted for age, sex, and CVD risk factors were used to assess associations of late‐onset asthma and incident CVD. The 1269 participants were 47.3 (8.0) years old; 166 participants had asthma (111 late‐onset, 55 early‐onset). Participants with late‐onset asthma compared to nonasthmatics were more likely to be female (67% versus 44%) and to have a higher body‐mass index (32.2 versus 29.4 kg/m²) (P<0 .05="" 39.5="" 8.9="" age="" asthma="" diagnosis="" early="" em="" group="" in="" late="" mean="" of="" onset="" style="border: 0px; font-weight: inherit; line-height: inherit; margin: 0px; outline-style: none; padding: 0px; text-align: inherit; vertical-align: baseline;" the="" versus="" was="" years="">P

<0 .0001="" 1.01="" 1.57="" 95="" a="" adjusted="" asthmatics="" ci="" cvd="" em="" had="" hazard="" higher="" incident="" late="" nbsp="" nonasthmatics="" of="" onset="" ratio="" risk="" style="border: 0px; font-weight: inherit; line-height: inherit; margin: 0px; outline-style: none; padding: 0px; text-align: inherit; vertical-align: baseline;" than="">P=0.045). There was no interaction between body‐mass index and age of asthma diagnosis on incident CVD (P=0.83).

Conclusions In a large cohort study of adults followed prospectively for over a decade, late‐onset asthmatics had an increased risk of incident CVD events that persisted after adjustment for age, sex, and CVD risk factors.

1. Figures Only
2. Full Text
3. PDF
4. PPT Slides of All Figures
5.