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Self-Reported Asthma Among High School Students:
United States, 2003
Morbidity and Mortality Weekly Report v.54, n.31 12aug2005
NEW YORK (Reuters Health) - While asthma does not seem to increase the risk of developing coronary heart disease, it may be a risk factor for stroke, researchers report.
Dr. A. R. Folsom from the University of Minnesota, Minneapolis, and colleagues used data from the Atherosclerosis Risk in Communities (ARIC) study to investigate the possible association between asthma, coronary heart disease and stroke.
Regardless of whether participants had asthma now or at some point in the past or never, their rates of coronary heart disease were not affected, the researchers report in the medical journal Thorax. [Abstract below]
In fact, asthma in men was associated with a lower incidence of coronary heart disease after taking account of major cardiovascular risk factors.
In contrast, the team found, ever having had asthma was associated with a 65 percent higher risk of stroke than never having had asthma. The risk with current asthma was somewhat higher, a 93 percent increase.
"If this observed association is causal," Folsom and colleagues write, "it adds to the significant burden that is imposed by asthma, a highly prevalent condition in the general population."
It is unclear "why asthma might increase the risk of stroke but not of coronary heart disease," the investigators write. "The biological mechanisms by which subjects with asthma may have an excess risk of stroke require further study," they conclude.
source: http://today.reuters.co.uk/news/newsArticle.aspx?type=healthNews&storyID=2005-08-09T204800Z_01_N09439670_RTRIDST_0_HEALTH-ASTHMA-STROKE-DC.XML 11aug2005
J G Schanen1, C Iribarren2, E Shahar1, N M Punjabi3, S S Rich4, P D Sorlie5 and A R Folsom1 1 Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA 2 Division of Research, Kaiser Permanente, Oakland, CA, USA 3 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA 4 Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA 5 Epidemiology and Biometry Program, NHLBI, Bethesda, MD, USA
Correspondence to: Dr A R Folsom University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA; folsom@epi.umn.edu
Background: A possible association between asthma and cardiovascular disease has been described in several exploratory studies.
Methods: The association of self-reported, doctor diagnosed asthma and incident cardiovascular disease was examined in a biracial cohort of 45–64 year old adults (N = 13501) followed over 14 years.
Results: Compared with never having asthma, the multivariate adjusted hazard ratio (HR) of stroke (n = 438) was 1.50 (95% CI 1.04 to 2.15) for a baseline report of ever having asthma (prevalence 5.2%) and 1.55 (95% CI 0.95 to 2.52) for current asthma (prevalence 2.7%). The relative risk of stroke was 1.43 (95% CI 1.03 to 1.98) using a time dependent analysis incorporating follow up reports of asthma. Participants reporting wheeze attacks with shortness of breath also had greater risk for stroke (HR = 1.56, 95% CI 1.18 to 2.06) than participants without these symptoms. The multivariate adjusted relative risk of coronary heart disease (n = 1349) was 0.87 (95% CI 0.66 to 1.14) for ever having asthma, 0.69 (95% CI 0.46 to 1.05) for current asthma at baseline, and 0.88 (95% CI 0.69 to 1.11) using the time dependent analysis.
Conclusions: Asthma may be an independent risk factor for incident stroke but not coronary heart disease in middle aged adults. This finding warrants replication and may motivate a search for possible mechanisms that link asthma and stroke.
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Abbreviations: CHD, coronary heart disease; CVD, cardiovascular disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; HR, hazards ratio; RR, risk ratio; SMR, standardised mortality ratio
Keywords: asthma; coronary heart disease; stroke
source: http://thorax.bmjjournals.com/cgi/content/abstract/60/8/633 12aug2005
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