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Asthma and incident cardiovascular disease: the Atherosclerosis Risk in Communities Study
  1. J G Schanen1,
  2. C Iribarren2,
  3. E Shahar1,
  4. N M Punjabi3,
  5. S S Rich4,
  6. P D Sorlie5,
  7. A R Folsom1
  1. 1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
  2. 2Division of Research, Kaiser Permanente, Oakland, CA, USA
  3. 3Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
  4. 4Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
  5. 5Epidemiology and Biometry Program, NHLBI, Bethesda, MD, USA
  1. 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;


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
  • asthma
  • coronary heart disease
  • stroke

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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.