Recent asthma symptoms or asthma that requires daily medication may significantly raise the risk of heart attack, according to two research papers presented at the American Heart Association's Scientific Sessions 2014.
"Physicians should do all they can to control every other modifiable cardiovascular risk factor in patients with asthma," said Matthew C. Tattersall, D.O., M.S., study author and an assistant professor of medicine in the Division of Cardiology at the University of Wisconsin-Madison School of Medicine and Public Health in Madison, Wisconsin.
Tattersall's study (Abstract 15991) involved 6,792 participants in the six-community Multi-Ethnic Study of Atherosclerosis (MESA), which tracks early signs of developing heart disease. Patients were an average 62 years old, 47 percent male, 28.4 percent Caucasian, 28 percent African-American, 22 percent Hispanic and 12 percent Chinese-American.
After adjustment for heart disease risk factors, researchers found that people with asthma who required daily medications were 60 percent more likely to have a cardiovascular event such as a heart attack, stroke or related condition during a 10-year follow-up than people without asthma.
Asthma and heart disease are associated with increased levels of inflammation in the body.
In the MESA study, asthmatics on controller medications, compared to non-asthmatics, had significantly higher levels of inflammatory markers including C-reactive protein and fibrinogen. The latter is a measure of blood stickiness that inflammation can worsen. Patients with a history of asthma but not currently requiring daily medication had intermediate levels of these markers.
In a study (Abstract 16110) in Olmstead County, Minnesota, researchers compared 543 patients who had a heart attack with 543 non-heart attack patients the same age and gender. The average age of patients was 67, 44 percent were women and 95 percent of the participants were Caucasian.
After controlling for traditional heart disease risk factors such as obesity, high blood pressure, smoking, diabetes and high cholesterol, researchers found that patients diagnosed with asthma had about a 70 percent higher risk of heart attack than those without asthma.
Patients with "active asthma" who had documented symptoms, medication use or visits to healthcare providers for asthma treatment within the previous year were twice as likely to have a heart attack than asthma patients with no recent symptoms.
"Chest discomfort or pain can be confused as a symptom of asthma, but because asthma increases the risk of heart attack and treatments for each are quite different, patients need to take chest pain and other symptoms of heart attack seriously and seek prompt treatment," said Young J. Juhn, M.D., M.P.H., senior author of the Olmstead County study and professor of pediatrics and adolescent medicine at the Mayo Clinic in Rochester, Minnesota.
Co-authors of the University of Wisconsin study are Mengye Guo, Ph.D.; Claudia E. Korcarz, D.V.M.; Adam D. Gepner, M.D.; R. Graham Barr, M.D., Dr.P.H.; Kathleen M. Donohue, M.D.; Robyn L. McClelland, Ph.D.; Joseph A. Delaney, Ph.D.; and senior author James H. Stein, M.D. Author disclosures are on the manuscript.
The Ruth L. Kirschstein National Research Service Award from the National Institutes of Health funded part of the study.
Co-authors of the Olmstead County study are Duk Won Bang, M.D., Ph.D.; Eun Na Kim, M.D.; Chung-il Wi, M.D.; John Hagan, M.D.; Veronique Roger, M.D., M.P.H.; Sheila Manemann, M.P.H.; and Brian Lahr, M.S. Author disclosures are on the manuscript.
The Scholarly Clinician Award from the Mayo Foundation funded the study.
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Note: Actual presentation for Tattersall's abstract (15991) is 9:30 a.m. CT/10:30 p.m. ET, Monday, Nov. 17, 2014. The actual presentation for Juhn' abstract (16110) is 3 p.m. CT/4 p.m. ET, Sunday, Nov. 16. 2014. (Both are in South Hall A2, Core 2.)
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