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Potential for repurposing oral hypertension/diabetes drugs to decrease asthma risk in obesity.

Akshay Sood1, Clifford Qualls2, Allison Murata2

  • 1Pulmonary, Critical Care and Sleep Medicine, University of New Mexico, Albuquerque, United States.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|July 7, 2022
PubMed
Summary
This summary is machine-generated.

Certain blood pressure medications, like ACE inhibitors and thiazolidinediones, may lower asthma risk in overweight or obese adults with diabetes or hypertension. Angiotensin receptor blockers, however, were linked to increased asthma risk.

Keywords:
Angiotensin converting enzyme inhibitoradiponectinangiotensin receptor blockerincident asthmaperoxisome proliferator-activated receptorthiazolidinediones

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Area of Science:

  • Pharmacology
  • Epidemiology
  • Respiratory Medicine

Background:

  • Overweight and obesity are linked to increased asthma risk, potentially mediated by adiponectin and peroxisome proliferator-activated receptor pathways.
  • Oral medications targeting these pathways, including ACE inhibitors (ACE-I), thiazolidinediones (TZD), and angiotensin receptor blockers (ARB), may mitigate this risk.

Purpose of the Study:

  • To investigate the association between the use of ACE-I, TZD, and/or ARB and the risk of new-onset asthma in overweight/obese adults with diabetes mellitus and/or hypertension.

Main Methods:

  • Longitudinal analysis of a large cohort of American veterans over 15 years.
  • Exposure defined by prescription pickup of ACE-I, TZD, and/or ARB for at least 4 weeks.
  • Survival analysis used to determine time to new-onset asthma, with propensity scoring to control for selection bias.

Main Results:

  • Use of ACE-I alone, TZD alone, or their combination was associated with a significantly decreased risk of incident asthma (HRs 0.88, 0.74, 0.20; p < 0.001).
  • Thiazolidinediones showed a greater risk reduction in racial/ethnic minority subjects compared to White participants (p < 0.001).
  • Angiotensin receptor blocker use, alone or with TZD, was associated with an increased risk of incident asthma.

Conclusions:

  • Angiotensin-converting enzyme inhibitors and thiazolidinediones are associated with a reduced risk of incident asthma in overweight/obese patients with diabetes and/or hypertension.
  • The findings suggest a potential protective role for ACE-I and TZD in asthma prevention within this patient population.