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Childhood asthma tied to increased LV mass index in adulthood
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Adults with a history of childhood asthma had an elevated left ventricular mass index, especially in those with prehypertension or hypertension, according to a study published in JACC: Heart Failure.
“Our findings suggest aggressive lifestyle modifications or even pharmacological treatment may be applied to people with a history of asthma, especially those also affected by high [BP], in order to lower [CV] risk,” Lu Qi, MD, PhD, director of the Tulane University Obesity Research Center in New Orleans, said in a press release.
Adults with asthma history
Researchers analyzed data from 1,118 participants (average age at baseline, 27 years) from the Bogalusa Heart Study to evaluate the link between childhood asthma and LV mass. Participants were followed up for an average of 10.4 years (average age at follow-up, 37 years).
The cutoff for prehypertension and hypertension was defined as systolic BP 130 mm Hg. Questionnaires were used to collect information on history of childhood asthma and demographics. Other measurements such as LV dimensions, BMI, systolic BP and plasma high-sensitivity C-reactive protein were taken.
Self-reported asthma was seen in 9.3% of participants (n = 104). Participants with asthma had a higher average BMI (31.5 kg/m2) than those without the condition (29.9 kg/m2; P = .04).
Asthma and LV mass
Compared with participants without asthma, those with asthma had a higher adjusted mean for LV mass (167.6 g vs. 156.9 g; P = .01) and LV mass index (41.1 g/m2.7 vs. 37.7 g/m2.7; P < .01) at follow-up after adjustment for sex, age, smoking status, race, heart rate, antihypertensive medication and systolic BP.
Researchers found that systolic BP affected the link between asthma and LV mass along with LV mass index (P for interaction < .01).
After adjustment for BMI and systolic BP, participants with asthma had a greater difference in LV mass index (39 g/m2.7; 95% CI, 37.4-40.6) compared with those without asthma (37.1 g/m2.7; 95% CI, 36.5-37.7; P = .03). The significant difference remained in patients with (38.4 g/m2.7; 95% CI, 36.6-40.3) and without asthma (36.6 g/m2.7; 95% CI, 35.7-37.4; P = .04) after adjusting for systolic BP, BMI and high-sensitivity CRP.
Compared with those with a systolic BP less than 130 mm Hg, the link between asthma and LV mass (regression coefficient, 39.5 vs. 2.3) and LV mass index (regression coefficient, 9 vs. 0.9) was stronger in participants with prehypertension and hypertension.
“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 [BP], to lower CV risk,” Qi and colleagues wrote.
“It remains unknown whether LV mass was associated with the severity of asthma and the frequency of use of corticosteroids and beta agonists, important information for selecting individuals who are at the highest risk,” John S. Gottdiener, MD, adjunct professor of medicine at University of Maryland School of Medicine in Baltimore, wrote in a related editorial. – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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