Asthma is associated with cardiovascular disease in a representative population sample

People with asthma may have an increased risk of cardiovascular disease (CVD) and metabolic disorders due to the direct involvement of common inflammatory mediators in the pathogenesis of CVD and insulin resistance. The aim of this study was to determine whether asthma was associated with an increased prevalence of CVD/stroke, and diabetes in a cross-sectional population study and whether the relationship was modified by obesity.

The North West Adelaide Health Study (NWAHS) (n = 4060, age ≥18 years) clinical assessment included spirometry, anthropometry, blood pressure, fasting lipids, glucose and HbA1c. Questionnaires assessed doctor diagnosed asthma, diabetes, CVD (myocardial infarction, angina)/stroke, smoking status, and demographics. Asthma was identified by self-report or significant bronchodilator reversibility of lung function.

After adjustment for known risk factors and confounders, asthma was not associated with diabetes (odds ratio (OR) = 1.06, 95% confidence interval (CI): 0.45-2.49, p = .91) yet remained positively associated with CVD/stroke (OR = 1.82, 95% CI: 1.20-2.73, p < 0.01) independent of the level of BMI (p for interaction between asthma and BMI = .22), smoking and lung function. Asthma was not positively associated with CVD risk factors or the metabolic syndrome.

In a representative population sample, asthma was associated with CVD/stroke after adjustment for traditional risk factors and lung function. Asthma may lead to CVD events via pathways unrelated to traditional risk factors and this requires further investigation. No significant effect modification by BMI was observed in relation to CVD, or diabetes.