Asthma and incident cardiovascular disease: the Atherosclerosis Risk in Communities Study
- 1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- 2Division of Research, Kaiser Permanente, Oakland, CA, USA
- 3Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
- 4Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- 5Epidemiology and Biometry Program, NHLBI, Bethesda, MD, USA
- Correspondence to:
Dr A R Folsom
University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA; folsomepi.umn.edu
- Received 8 April 2004
- Accepted 16 March 2005
Abstract
Background: A possible association between asthma and cardiovascular disease has been described in several exploratory studies.
Methods: The association of self-reported, doctor diagnosed asthma and incident cardiovascular disease was examined in a biracial cohort of 45–64 year old adults (N = 13501) followed over 14 years.
Results: Compared with never having asthma, the multivariate adjusted hazard ratio (HR) of stroke (n = 438) was 1.50 (95% CI 1.04 to 2.15) for a baseline report of ever having asthma (prevalence 5.2%) and 1.55 (95% CI 0.95 to 2.52) for current asthma (prevalence 2.7%). The relative risk of stroke was 1.43 (95% CI 1.03 to 1.98) using a time dependent analysis incorporating follow up reports of asthma. Participants reporting wheeze attacks with shortness of breath also had greater risk for stroke (HR = 1.56, 95% CI 1.18 to 2.06) than participants without these symptoms. The multivariate adjusted relative risk of coronary heart disease (n = 1349) was 0.87 (95% CI 0.66 to 1.14) for ever having asthma, 0.69 (95% CI 0.46 to 1.05) for current asthma at baseline, and 0.88 (95% CI 0.69 to 1.11) using the time dependent analysis.
Conclusions: Asthma may be an independent risk factor for incident stroke but not coronary heart disease in middle aged adults. This finding warrants replication and may motivate a search for possible mechanisms that link asthma and stroke.
- CHD, coronary heart disease
- CVD, cardiovascular disease
- FEV1, forced expiratory volume in 1 second
- FVC, forced vital capacity
- HR, hazards ratio
- RR, risk ratio
- SMR, standardised mortality ratio
Footnotes
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The Atherosclerosis Risk In Communities (ARIC) Study was funded by contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, N01-HC-55022 from the US National Heart, Lung, and Blood Institute.









