Adults with asthma experience more nonrespiratory diseases than those without asthma

Adults with asthma experienced more nonrespiratory diseases and multimorbidity than adults without asthma, according to a study published in The Journal of Allergy and Clinical Immunology: In Practice.

Although the types of these diseases varied, their frequency increased with age at asthma diagnosis, Jasmin Honkamäki, MD, academic researcher with the Faculty of Medicine and Health Technology of Tampere University in Tampere, Finland, and colleagues wrote.

The researchers examined 8,199 responses (median age, 50 years; 44.9% men) to a FinEsS questionnaire sent to 16,000 individuals aged 20 to 69 years in Finland in 2016.

The respondents included 879 who reported physician-diagnosed asthma. Of the 842 respondents who reported age at asthma diagnosis, 29.1% had early diagnosis (age 0-11 years), 42.5% had intermediate diagnosis (age 12-39 years) and 28.4% had late diagnosis (age 40-69 years). Respondents with asthma had a younger median age than those without asthma (47 years vs. 50 years; P = .006).

The questionnaire asked about COPD, allergic rhinitis, asthma medication use and 14 nonrespiratory diseases.

Most of these diseases were more prevalent among the patients with asthma, even when researchers excluded patients with COPD.

Hypertension was the most common disease — with the highest rates seen for those without asthma (18.9%) and with late-diagnosed asthma (42.3%) — followed by obesity, at rates of 17.5% among those with early-diagnosed asthma and 21.1% for intermediate-diagnosed asthma.

Overall, those with intermediate- and late-diagnosed asthma had significantly more GERD, depression, sleep apnea, painful conditions and obesity than those without asthma.

Similarly, those with intermediate-diagnosed asthma had more anxiety or panic disorder, and those with late-diagnosed asthma had more hypertension, severe cardiovascular disease, arrhythmia and diabetes than those with no asthma.

A greater proportion of patients with asthma had one or more nonrespiratory diseases (58.7% vs. 47%; P < .001), with the highest number among the group with late-diagnosed asthma. Age-adjusted analyses also found that 12.1% of those with intermediate-diagnosed asthma and 36.2% of those with late-diagnosed asthma had three or more non-respiratory diseases compared with 10.4% of those with no asthma (P < .001 for both).

In multivariable binary logistic regression analysis adjusted by age and sex, individuals with vs. without asthma were significantly more likely to have GERD, COPD and one or more respiratory disease across age of diagnosis categories.

Compared with individuals without asthma, GERD was the most overrepresented disease among patients with early-diagnosed asthma (OR = 1.93; 95% CI, 1.17-3.19), whereas osteoporosis was the most overrepresented disease among patients with intermediate-diagnosed (OR = 3.45; 95% CI, 2.01-5.91) and late-diagnosed (OR = 2.91; 95% CI, 1.77-4.79) asthma.

When the researchers adjusted their regression analysis by COPD, smoking and BMI in addition to age and sex, the association between late-diagnosed asthma and hypertension, severe cardiovascular disease and diabetes lost its association.

Overall, the adults with asthma experienced more nonrespiratory diseases and more multimorbidity than those who did not have asthma, with a greater number of nonrespiratory diseases with older ages at asthma diagnosis compared with diagnoses at younger ages in adjusted analyses.

A better understanding of comorbid diseases could lead to more holistic and personalized treatment with enhanced asthma control, the researchers wrote, adding that studies of adult asthma should more readily note these comorbid diseases.