[The features of risk factors, systemic inflammation, and endothelial dysfunction in patients with asthma concurrent...

To identify risk factors (RFs), to evaluate the impact of systemic inflammation and endothelial dysfunction on the development of asthma concurrent with coronary heart disease (CHD), and to determine the degree of control of the disease.

The clinical trial included 50 asthmatics aged 40-75 years with CHD. All the patients underwent external respiratory function (ERF) test, ECG, blood pressure and anthropometric measurements, and bicycle ergometry. Their medical and allergy history data were collected and RFs and basic therapy were assessed. Laboratory blood and urine values and endothelial function were estimated determining the brachial artery diameter and the time-averaged maximal linear velocity (TAMX) of blood flow in endothelium-dependent and endothelium independent vasodilation (VDV and VIDV).

The development of asthma in the presence of CHD was found to be associated with RFs, such as female gender (66%), hereditary asthma (40%) and CHD (76%), hypertension (86%), obesity (42%), smoking (7%), occupational exposures (20%), and dyslipidemia. Laboratory tests in the asthmatic patients with CHD revealed a positive C-reactive protein reaction (CRP) in 16 (32%) patients and increased serum cholesterol levels. Reactive hyperemia and nitroglycerin tests in the patients with asthma concurrent with CHD showed that the BA diameter was significantly increased up to 4.27 +/- 0.3 and 4.54 +/- 0.03 mm, respectively, as compared to the baseline values (p < 0.01). Most patients were observed to have marked and frequent symptoms of the disease, frequent asthma exacerbations, and impaired ERF and to need "rescue" bronchodilators.

RFs, such as female gender, family history, hypertension, obesity and dyslipidemia play an important role in the development of asthma concurrent with CHD. Impaired TAMX, VDV, and VIDV, hypercholesterolemia and higher CRP levels were detected. Basic therapy in the patients with asthma concurrent with CHD was not optimal or rather effective since disease control was not achieved in 70% of the patients.