Persistent asthma may drive higher carotid plaque burden
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Adults with persistent asthma, but not those with intermittent asthma, have a higher carotid plaque burden compared with those without asthma, according to research published in the Journal of the American Heart Association.
In an analysis of participants enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA), researchers also found that adjustment for inflammatory markers did not attenuate the association of persistent asthma and carotid plaque presence or burden, suggesting that atherosclerotic CVD risk among people with asthma may be multifactorial.
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“In the MESA, the prevalence of asthma was [about] 10%, which is similar to the national prevalence of asthma in the United States,” Matthew C. Tattersall, DO, MS, assistant professor in the division of cardiovascular medicine, director of cardiac rehabilitation and co-director of the Advanced Hypertension Clinic at the University of Wisconsin School of Medicine, and colleagues wrote. “The lack of association of intermittent asthma and carotid plaque measures is not unexpected, highlights the heterogeneity of the asthma syndrome, and supports our hypothesis that more severe forms of the disease may have more carotid arterial injury manifestations.”
Tattersall and colleagues analyzed data from 5,029 MESA participants who were free of CVD at baseline. The mean age of participants was 62 years; 53% were women, 26% were Black, 23% were Hispanic and 12% were Chinese. Researchers assessed asthma subtype at the first examination; persistent asthma was defined as asthma requiring use of controller medications and intermittent asthma was defined as asthma without controller medications. Participants underwent B-mode carotid ultrasound to detect carotid plaques (total plaque score range, 0-12). Researchers assessed the association of asthma subtype and carotid plaque burden.
Within the cohort, 50.5% of participants without asthma had carotid plaque present (mean total plaque score, 1.29). Among participants with asthma, 49.5% of those with intermittent asthma and 67% of those with persistent asthma had carotid plaque present (P for comparison of proportions < .003). Compared with participants without asthma, those with persistent asthma had higher mean levels of interleukin (IL)-6 (1.89 pg/mL vs. 1.52 pg/mL; P = .02).
In fully adjusted models, persistent asthma was associated with carotid plaque presence, with an OR of 1.83 (95% CI, 1.21-2.76; P < .001). Results persisted after adjustment for baseline IL-6 level (P = .02) and C-reactive protein level (P = .01), indicating increased ASCVD risk among adults with persistent asthma “may be multifactorial,” according to the researchers.
Persistent asthma was also associated with total plaque score (beta = 0.66; P < .01), even after adjustment for IL-6 and CRP, the researchers wrote.
“The most important message from our findings is that more significant forms of asthma are associated with more CVD and CV events,” Tattersall said in a press release. “Addressing CV risk factors through lifestyle and behavior adjustments can be a powerful preventive tool for patients with more severe forms of asthma.”
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