LateOnset Asthma & Cardiovascular

Disease Risks
by Rob Chakler | Feb 22, 2017 | Cardiology, Emergency Medicine, Hospital Medicine,humira-
tablet, Pulmonology/Critical Care, Recent Features, Slider, Tablet
Asthma is a heterogeneous syndrome in which presentations can vary significantly between
patients.
Although it is not usually recognized as such, there are different clinical subtypes of asthma, each
with unique pathophysiology. Specific subtypes may be associated with an increased risk for
cardiovascular disease (CVD). Asthma and CVD may be interconnected, but studies indicating a
cause-and-effect relationship between the conditions have been mixed, says Matthew C.
Tattersall, DO, MS.
For a study published in the Journal of the American Heart Association , Dr. Tattersall and
colleagues investigated if lateonset subtype of asthma is associated with a higher risk of incident
CVD. This type of asthma tends to be more severe and more difficult to control with medications
than early-onset asthma, notes Dr. Tattersall. He and his colleagues followed participants from
the Wisconsin Sleep Cohort who did not have CVD at baseline and tracked them for an average of
nearly 14 years. The analysis involved 1,269 patients aged 47, on average; 111 of these patients
had late-onset asthma whereas 55 had early-onset asthma.
Important Findings
Our study showed that patients with late-onset asthma were nearly 60% more likely than those
without asthma to experience a CVD event, such as a heart attack, stroke, heart failure, angina,
and/or cardiovascular-related death, Dr. Tattersall says. Study participants with lateonset
asthma were more likely than those without the disease to be a woman (67% vs 44%) and to have
a higher BMI (32.2 kg/m2vs 29.4 kg/m2). The average age of an asthma diagnosis in the lateonset
group was 39.5 years, compared with 8.9 years for the earlyonset group. However, there
appeared to be no interaction between BMI and age of asthma diagnosis on incident CVD.
Considering Implications
According to Dr. Tattersall, late-onset asthma is difficult to control and often caused by various
other factors. These patients also commonly experience more rapid declines in lung function,
he says. Our research was observational by nature, so the findings do not imply a causal
relationship. Instead, the results suggest that there may be a common pathway for both asthma
and CVD. Clinicians should recognize the overlap of symptoms for these conditions and may need
to take more aggressive preventive measures to ensure that patients with late-onset asthma do
not develop CVD.
More research into the causes of the observed association is needed because it may have
treatment implications, says Dr. Tattersall. In the meantime, physicians should closely monitor
CVD risk factors, such as blood pressure and cholesterol levels, when managing patients with
asthma, he says. If these levels are elevated, its critical to aggressively address these risk
factors with pharmacologic therapies, lifestyle modifications, or both. The study adds that these
patients should also be instructed to help themselves by exercising more, eating a healthy diet,
and maintaining a normal body weight.
Matthew C. Tattersall, DO, MS, has indicated to Physicians Weekly that he has received
grants/research aid from the NIH (T32 HL07936).