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Title: Adult-Onset Asthma to Coronary Heart Disease and Stroke

item Onufrak, Stephen
item Abramson, Jerome
item Austin, Harland
item Holguin, Fernando
item Mcclellan, William
item Vaccarino, Viola

Submitted to: American Journal of Cardiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/19/2007
Publication Date: 5/1/2008
Citation: Onufrak, S.J., Abramson, J., Austin, H., Holguin, F., McClellan, W., Vaccarino, V. 2008. Adult-Onset Asthma to Coronary Heart Disease and Stroke.American Journal of Cardiology. 1019:1247-1252.

Interpretive Summary: Asthma is a common chronic disease with many epidemiologically and biologically different subtypes that also differ by gender. Several research studies have suggested that asthma may be a risk factor for cardiovascular disease but these studies have not examined specific asthma subtypes in this relationship. This research study suggests that asthma’s relationship with cardiovascular disease differs greatly by asthma subtype and gender.

Technical Abstract: Asthma has been associated with atherosclerotic disease in several studies with some evidence that this association may be limited to women. However, most previous studies have failed to account for the heterogeneity of asthma subtypes. We previously reported increased carotid intima medial thickness among women with adult onset asthma. In this study, we examine the association of adult and child onset asthma with incident coronary heart disease (CHD) and stroke. Subjects were classified according to self-report of physician diagnosed asthma and age of asthma onset. We used Cox proportional hazards models to test the association of adult and child onset asthma with incident CHD and stroke, testing for gender interaction. Subanalysis was also performed using only neversmokers. Women with adult onset asthma experienced a two-fold increase in incident CHD and stroke which was independent of other risk factors including smoking, body mass index, and physical activity and persisted when the analysis was restricted to never-smokers. No significant association was found among women with child onset asthma or among men. Adult onset asthma may be a significant risk factor for CHD and stroke among women but not men. Further research on cardiovascular disease among asthmatics should focus on asthma subtypes.