Asthma and cardiovascular disease: A bidirectional association?

Childhood asthma was associated with the presence of cardio-cerebrovascular diseases in US middle-aged and elderly

Background

Asthma and cardio-cerebrovascular diseases (CVDs) share a common etiology of chronic systemic inflammation. Our manuscript was to investigate the association between childhood asthma and CVDs in middle-aged and elderly.

Methods

A total of 12,070 US middle-aged and elder were enrolled in the National Health and Nutrition Examination Survey. Childhood asthma was defined as a previous diagnosis of asthma at <18 years of age. Associations between childhood asthma and overall and cause-specific CVDs were evaluated using multivariable logistic regression models and subgroup analyses, including coronary artery disease (CAD), angina, and stroke.

Results

The prevalence of CVDs, including CAD (p = 0.031) and angina (p < 0.001), was significantly higher in patients with asthma (p = 0.008). Asthma was independently associated with a higher risk of CVDs (odds ratio [OR]:1.50, 95 % confidence interval [CI]: 1.22-1.84, p < 0.001), CAD (OR: 1.55, 95 %CI: 1.17-2.02, p = 0.002), and angina (OR: 1.93, 95 %CI: 1.42-2.58, p < 0.001) while not related to stroke (p = 0.233). Subgroup analysis suggested that the association was consistent across sex, race, and the presence of obesity, chronic obstructive pulmonary disease, and diabetes.

Conclusions

Childhood asthma was significantly associated with the presence of cardiocerebrovascular diseases, including CAD and angina in middle-aged and elderly. These findings underscore the importance of addressing childhood asthma as a potential risk factor for cardiovascular morbidity in middle-aged and elderly populations.

Life's Essential 8, genetic predisposition, and risk of incident adult-onset asthma: a prospective cohort study

BACKGROUND

Adult-onset asthma (AOA) and cardiovascular diseases shared common risk factors and similar pathophysiologic resemblances. The American Heart Association (AHA) unveiled the life's essential 8 (LE8) to promote cardiovascular health (CVH). This study aimed to assess the overall impact of LE8 implementation on AOA prevention.

METHODS

According to the guideline of AHA's Construct of CVH in 2022, LE8 score was calculated from 8 health status concerning diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional-hazards models were used to estimate effect sizes of associations between CVH, asthma genetic risk, and risk of incident AOA in participants selected from the UK Biobank study.

RESULTS

A total of 6180 incident AOA cases occurred in 249,713 participants during an average of 11.60 y' follow-up. A higher LE8 score was associated with a lower risk of incident AOA with a significant linear trend (P < 0.0001). Every standard deviation increment of LE8 was associated with a 17% (HR: 0.83; 95% CI: 0.81, 0.85) lower risk of incident AOA. Compared with participants with low-CVH score, participants with moderate (HR: 0.72; 95% CI: 0.67, 0.78) and high CVH scores (HR: 0.52; 95% CI: 0.47, 0.58) were associated with a lower risk of incident AOA (P-trend < 0.0001). No significant multiplicative or additive interaction was found between LE8 score and genetic risks. Stratified analysis showed a consistent association between CVH and risk of incident AOA across different asthma polygenic risk score (PRS) levels. Compared with participants with high PRS and low CVH, participants with low PRS and high CVH experienced the lowest risk (HR: 0.28; 95% CI: 0.23, 0.34) of incident AOA.

CONCLUSIONS

Our findings suggest that maintaining optimal CVH should be recommended as a preventive strategy for AOA, regardless of their asthma genetic risks.

Association between Asthma and Periodontitis

The current study aimed to investigate the association between asthma and periodontitis in the Korean adult population. Data from the Korean Genome and Epidemiology Study Health Examinees between 2004 and 2016 were considered. Of the 173,209 participants, 2521 asthmatic and 132,806 control participants were selected. The participants were categorized according to their current status of asthma, as 'well-controlled', 'being treated', and 'not being treated'. The prevalence of periodontitis was found to be significantly higher in the participants with asthma (13.1%) than in the controls (7.3%). In the fully adjusted model, the patients with asthma had a higher odds ratio (OR = 1.79, 95% confidence interval [CI] = 1.59-2.02, p < 0.001) for periodontitis than those without asthma. The results were consistent across all the age and sex subgroups. The adjusted ORs for periodontitis were 2.15 (95% CI = 1.68-2.76, p < 0.001) in the 'well-controlled' asthma group, 1.44 (95% CI = 1.16-1.78, p < 0.001) in the 'being treated' asthma group, and 1.86 (95% CI = 1.55-2.22, p < 0.001) in the 'not being treated' asthma group compared to the control group. Overall, we found asthma to be associated with periodontitis in Korean adults, and the participants with well-controlled asthma had the highest ORs for periodontitis.