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https://hdl.handle.net/2440/53340
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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 1097-6825 |
Statement of Responsibility: | 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. |
DOI: | 10.1016/j.jaci.2008.10.032 |
Published version: | http://dx.doi.org/10.1016/j.jaci.2008.10.032 |
Appears in Collections: | Aurora harvest Medicine publications |
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