Patients with asthma, hypertension trend older with higher BMI

Key takeaways:

• Smokers, former smokers and patients with BMI greater than 30 kg/m² were excluded to reduce cardiovascular risk factor impact.
• Hypertensive patients were more likely to report gastroesophageal reflux disease.

SAN DIEGO — Patients with asthma and hypertension tended to be older and had higher BMI than those patients with asthma who did not have hypertension, according to a presentation at the American Thoracic Society International Conference.

These factors are associated with higher cardiovascular risks, Francesco Ardesi, MD, physician, department of medicine and surgery, University of Insubria, and colleagues wrote.

“We decided to understand if hypertension can have an impact on other comorbidities in asthmatics,” Ardesi told Healio.

Although patients with asthma often have hypertension, the researchers said, their relationship has not been fully investigated.

This retrospective observational study included 142 adults with asthma (median age, 58 years; 36% men) with at least one induced sputum, which the researchers called a test for investigating central inflammatory characteristics.

The study excluded patients who used oral corticosteroids, smokers and former smokers, as well as patients who were aged 65 years and older and those with BMI higher than 30 kg/m² to reduce the impact of cardiovascular risk factors, Ardesi said.

The cohort included 36 patients (25%) who were hypertensive. Compared with the patients who were not hypertensive, the hypertensive group was older (63 years vs. 54 years) and had higher BMI (26 kg/m² vs 24 kg/m²; P = .005).

Also, 42% (n = 15) of the hypertensive group and 22% (n = 23) of the non-hypertensive group had gastroesophageal reflux disease (P = .019).

But there were no significant differences between the groups in lung function or asthma control based on Asthma Control Questionnaire-6 scores, median numbers of exacerbations, FEV₁, forced vital capacity and other metrics, Ardesi said.

Blood leukocyte counts included 6,950 for the hypertensive group and 6,400 for the non-hypertensive group (P = .034). Similarly, blood neutrophil counts included 4,089 for the hypertensive group and 3,522 for the non-hypertensive group (P = .029).

The researchers also noted a positive correlation between blood eosinophil counts and sputum eosinophil percentages (P < .001; r = 0.717; R² = 0.375) in the non-hypertensive group, but the hypertensive group did not share this significant correlation.

Further, the researchers said there were no significant differences between the groups in terms of airway inflammation.

The researchers said these findings may be due to the influence of hypertension or to a systemic metabolic condition, so they must be confirmed with further prospective studies to better understand this relationship.

“This is just the beginning,” Ardesi said. “We are planning on a prospective study.”

Meanwhile, respiratory specialists can manage some but not all these comorbidities, making referrals essential for patients with both asthma and hypertension, Antonio Spanevello, MD, FERS, director of the postgraduate school in respiratory diseases, University of Insubria, told Healio.

“The real problem is that it is not so easy to create a multidisciplinary approach,” Spanevello said. “We have the patient, we measure hypertension, and we know to ask the cardiologist to come.”

For more information:

Francesco Ardesi, MD, can be reached at f.ardesi@uninsubria.it.