According to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association, adults with persistent asthma may be more likely to experience a heart attack or stroke as a result of excessive plaque buildup in the carotid arteries. Compared to those without asthma, participants in the study had increased plaque formation in their carotid arteries—large arteries on the left and right sides of the neck that supply blood to the brain.
A person with asthma has trouble breathing because their airways become inflamed frequently as a result of allergic responses. It is well recognized that chronic inflammation over time contributes to the development of artery plaques known as atherosclerosis and is linked to an increased risk of plaque rupture, which could result in a heart attack or stroke.
For people with persistent asthma, addressing risk factors for cardiovascular disease may be really helpful, according to lead study author Matthew C. Tattersall, D.O., M.S., assistant professor in the department of medicine at the University of Wisconsin in Madison. “Many physicians and patients don’t realize that asthmatic airway inflammation may affect the arteries,” he said. Future cardiovascular events can be strongly predicted by the presence and burden of carotid artery plaque, according to research.
The Multi-Ethnic Study of Atherosclerosis (MESA) study data were utilized to conduct this analysis, which looked at the possible relationship between carotid artery plaque and asthma. In six different American locations—Baltimore, Chicago, New York, Los Angeles County, California, Forsyth County, North Carolina, and St. Paul, Minnesota—MESA, a study of nearly 7,000 adults, has been ongoing since 2000. All MESA patients were free of cardiovascular disease at the time of inclusion.
Five thousand two hundred and nine adults with an average age of 61 who had baseline cardiovascular disease risk factors and carotid ultrasonography data had their health records evaluated by the researchers. The participant population is varied, with 26% of adults identifying as African American, 23% as Hispanic, and 12% as Chinese. In addition, there were 53% female members of the group.
The cohort of participants in this analysis was divided into three groups: those with persistent asthma, those with intermittent asthma, and those without asthma. There were 109 participants in the subgroup with persistent asthma, which was defined as using daily controller medications to control asthma symptoms. There were 388 participants in the subgroup with intermittent asthma, which was defined as having a history of asthma but not using daily medications to control asthma symptoms.
All participants in the MESA study underwent an ultrasound of their left and right carotid arteries prior to the study’s start in order to look for any carotid artery plaque. The number of plaques in the walls of both carotid arteries was determined by the total plaque score. At the beginning of the MESA trial, blood levels of the inflammatory biomarkers interleukin-6 (IL-6) and C-reactive protein (CRP) were also assessed.
The research revealed:
- 67% of patients with persistent asthma and 49.5% of people with intermittent asthma had carotid plaque. There were often two carotid plaques in those with persistent asthma, compared to one in people with intermittent asthma.
- 50.5% of the people who did not have asthma had carotid plaque, with an average of one plaque.
- Individuals with persistent asthma had nearly two times the likelihood of developing plaque in their carotid arteries than participants without asthma, even after controlling for age, sex, race, weight, other medical problems, prescription medication usage, and smoking.
Participants with persistent asthma reported greater levels of inflammatory biomarkers compared to those without asthma. The average IL-6 level in people with persistent asthma was 1.89 pg/mL, compared to 1.52 pg/mL in people without asthma. The relationship between persistent asthma and carotid artery plaque was not diminished, the researchers discovered, even after taking into account IL-6 and CRP in the fully adjusted study.
According to this data, people with persistent asthma are more likely to develop carotid plaques than those who do not, according to Tattersall. “Even if their asthma was being managed with medicine, participants who had chronic asthma still had elevated levels of inflammation in their blood, which emphasizes the inflammatory characteristics of asthma.” “We are aware that increased inflammation has harmful effects on the cardiovascular system.”
Inflammatory diseases like arthritis and lupus were listed as cardiovascular risk-enhancing variables in the American Heart Association’s 2019 primary prevention of cardiovascular disease guidelines. This study advances knowledge of how inflammatory illnesses affect cardiovascular health.
The main takeaway from our research, according to Tattersall, is that more severe forms of asthma are linked to increased cardiovascular disease and cardiovascular events. “For individuals with more severe forms of asthma, addressing cardiovascular risk factors through lifestyle and behavior changes can be a powerful preventive intervention.”
The American Heart Association’s “Life’s Essential 8” guidelines, which include eating well, exercising, quitting smoking, getting enough sleep, maintaining a healthy weight, and managing blood pressure, blood sugar, and cholesterol levels, can help anyone improve their cardiovascular health. According to the American Heart Association, cardiovascular disease claims more lives annually in the United States than all types of cancer and chronic lower respiratory disease put together.
The primary drawback of the study was that it was observational because it was data analysis; hence, the results show an association, not a cause-and-effect relationship, between asthma and a higher risk of cardiovascular disease.
