ORLANDO – A history of asthma was independently associated with a 24% increase in the risk of new-onset coronary heart disease among postmenopausal women in an analysis from the Women’s Health Initiative.
The study cohort included 90,168 women aged 50-79 years who were free of cardiovascular disease at enrollment in the Women’s Health Initiative (WHI), of whom 6,921 reported a history of physician-diagnosed asthma at baseline. During follow-up in the prospective study, the incidence of a CHD event was 8.6% in subjects with a history of asthma and 6.97% in the no-asthma group, Dr. Fady Y. Marmoush reported at the American Heart Association scientific sessions.
Moreover, the incidence of a first cardiovascular event was 11.6% in the asthma group, compared with 9.7% in the no-asthma controls, added Dr. Marmoush of Memorial Hospital of Rhode Island, Pawtucket.
The asthma group had an absolute 1%-2% greater baseline prevalence of hypertension, diabetes, and family history of CHD. Those with asthma also were more likely to be obese. On the other hand, they were less likely to have ever smoked.
In a multivariate analysis adjusted for these and other potential confounders, including age, dyslipidemia, and waist-hip ratio, the women with a history of asthma had a 24% greater risk of CHD during prospective follow-up in the WHI, as well as a 21% increased rate of cardiovascular events, including stroke, compared with the no-asthma group.
Thus, a history of asthma could be a useful consideration – a tie breaker of sorts – in older women whose calculated 10-year atherosclerotic cardiovascular disease risk based on the standard risk factors places them on the borderline as candidates for statin therapy. The most likely mechanism for the observed association between asthma history and increased risk of cardiovascular disease is the chronic inflammatory state that’s a hallmark of asthma accelerating the atherosclerotic process, which also is inflammatory, she said.
The WHI is funded by the National Heart, Lung, and Blood Institute. Dr. Marmoush reported having no financial conflicts.