Asthma History Linked to Left Ventricular Disease

[[{"type":"media","view_mode":"media_crop","fid":"61704","attributes":{"alt":"","class":"media-image","id":"media_crop_3987915171472","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"7804","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 426px; width: 636px;","title":" ","typeof":"foaf:Image"}}]]A history of asthma can increase the risk for left ventricular hypertrophy, in particular for those adults with pre-hypertension and hypertension, according to a new study.

In this prospective cohort study with an average 10 years of follow-up, adults with a history of asthma from childhood had a significantly greater left ventricular mass index (LVMI) compared with adults without asthma, independent of major cardiovascular disease (CVD) risk factors, including age, sex, race, smoking status, antihypertensive medication, high-sensitivity c-reactive protein (hs-CRP), heart rate, body mass index (BMI), and systolic blood pressure (SBP).

“We found that a history of asthma from childhood appeared to be associated with an increased risk for elevated LVMI among apparently healthy young adults,” state the researchers, led by Dianjianyi Sun, MD, PHD of the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA.

The researchers published their results in the July 2017 JACC: Heart Failure.

Sun and colleagues conducted prospective analyses of 1,118 participants, average age 36.7 years at follow-up, in the Bogalusa Heart Study who had a baseline history of self-reported asthma collected since childhood. At two to four time points during follow-up, left ventricular mass was assessed by echocardiography and was indexed for body height as LVMI.

Those with a history of asthma had a higher adjusted mean left ventricular mass, as well as a higher LVMI, compared with those who did not have a history of the disease.

The difference of LVMI between the group with asthma and the group without asthma remained significant after additional adjustment for BMI and hs-CRP. In addition, the researchers found significant interactions between SBP and asthma on left ventricular mass and LVMI.

The associations between asthma and left ventricular measures appeared to be stronger among pre-hypertensive and hypertensive participants compared with those with normal SBP.

“Our data suggest that aggressive lifestyle modifications or even pharmacological treatment may be applied to people with a history of asthma, especially those also affected by high blood pressure, to lower CV risk,” they stated.

The mechanisms underlying this epidemiologic association remain unclear. Previous studies have found systemic inflammation to have a role in the relationship between asthma and cardiovascular disorders, the researchers noted. They suggest that other potential pathways could be involved, such as pulmonary function decline in asthmatic patients. Asthma medications, such as oral corticosteroids and inhaled beta 2-agonists, have been linked with increased CVD events and death. Also, they point out that asthmatic patients can be more physically inactive, obese, and hypertensive, as well as more predisposed to diabetes, chronic obstructive pulmonary disease, and arthritis, and these risk factors could also affect left ventricular hypertrophy.

Limitations of the study, they noted, include collection of asthma history through questionnaires rather than clinical records, and that some of the records were followed for less than 1 year from baseline.

Further studies are warranted to verify the findings, they stated, in particular, to learn how severe and how long the asthmatic exposure needs to be to pose significant risk.