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Type: Journal article
Title: Cardiovascular disease risk associated with asthma and respiratory morbidity might be mediated by short-acting beta(2)-agonists
Author: Appleton, S.
Ruffin, R.
Wilson, D.
Taylor, A.
Adams, R.
Citation: Journal of Allergy and Clinical Immunology, 2009; 123(1):124-130
Publisher: Mosby Inc
Issue Date: 2009
ISSN: 0091-6749
Statement of
Sarah L. Appleton, Richard E. Ruffin, David H. Wilson, Anne W. Taylor, Robert J. Adams and North West Adelaide Cohort Health Study Team
Abstract: Background Studies examining the asthma-related risks of cardiovascular disease (CVD) events have generally used selected samples or did not control for the effects of β2-agonist use, itself associated with CVD events. Objectives We assessed the relationship between incident CVD/stroke and asthma and the effect of atopy while controlling for β2-agonist use in a representative adult population cohort free of CVD at baseline. Methods The North West Adelaide Health Study (stage 1, n = 3812; stage 2, n = 3113) assessed spirometry, anthropometry, atopy, blood pressure, and lipid levels. Questionnaires assessed doctor-diagnosed asthma and CVD (myocardial infarction and angina)/stroke, smoking status, and demographics. Asthma was defined by self-report or FEV1 reversibility. Current short- and long-acting β2-agonist use was identified at follow-up. Results Results are expressed as odds ratios (ORs) and 95% CIs. By using multivariable logistic regression, after adjustment for risk factors, in female subjects incident CVD/stroke events were associated with asthma (OR, 3.24; 95% CI, 1.55-6.78), with no effect modification by atopy (P for interaction = .61), and with as-required short-acting β2-agonist use (OR, 2.66; 95% CI, 1.06-6.61). In male subjects events were associated with daily cough/sputum (OR, 1.92; 95% CI, 1.05-3.50) and FEV1 of less than 80% of predicted value but an FEV1/forced vital capacity ratio of greater than 0.70 (OR, 2.15; 95% CI, 0.91-5.09; P = .08). Although few CVD/stroke events occurred in male subjects with asthma, a significant interaction with atopic status was found (P = .05). Conclusions Studies are required to elucidate how asthma exposes older women to excess macrovascular risk and prospectively determine the short-acting β2-agonist–related risk in persons without existing CVD. CVD risk in relation to atopic status of asthma also requires further investigation.
Keywords: Adrenergic β-agonists; asthma; cardiovascular system; epidemiology; lung diseases; obstructive
Description: Copyright © 2009 American Academy of Allergy, Asthma & Immunology Published by Mosby, Inc.
RMID: 0020090104
DOI: 10.1016/j.jaci.2008.10.032
Appears in Collections:Medicine publications

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