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4CPS-192 Asthma and risk of cardiovascular events: a retrospective study
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  1. P Granda Lobato1,
  2. E Villamañán2,
  3. L De Las Vecillas3,
  4. D Laorden4,
  5. VL Collada2,
  6. C Mateos2,
  7. A Hoyo2,
  8. L Garcia2,
  9. R Álvarez-Sala4,
  10. A Herrero2
  1. 1Hospital Central De La Defensa Gómez Ulla, Pharmacy, Madrid, Spain
  2. 2Hospital Universitario La Paz, Pharmacy, Madrid, Spain
  3. 3Hospital Universitario La Paz, Allergology, Madrid, Spain
  4. 4Hospital Universitario La Paz, Pneumology, Madrid, Spain

Abstract

Background and Importance Asthma is frequently associated with respiratory and non-respiratory comorbidities. Non-respiratory comorbid conditions include cardiovascular disease; indeed, asthma has been linked with increased risk of cardiovascular events, although its prevalence varies between studies and robust evidence of this relationship is limited.

Aim and Objectives The aim of this study was to identify and assess cardiovascular disease risk for asthma patients.

Material and Methods Retrospective cohort study involving patients followed-up by the severe asthma unit of a tertiary care hospital in Spain. Sociodemographic variables included sex and age. The clinical variables were comorbidities (obesity, BMI>30; type 2 diabetes; arterial hypertension; dyslipidaemia and other respiratory conditions), smoking status, asthma phenotype, biomarker concentrations (fractional exhaled nitric oxide [FeNO], total and specific serum IgE and blood eosinophil count [BEC]) and lung function. Treatment with biologics for asthma, systemic and inhaled corticosteroids, inhaled short-acting beta-agonists and antihypertensive medication were also recorded. Patients with a cardiovascular event prior diagnosis of asthma were excluded. History of cardiovascular events was obtained and odds ratios (ORs) for cardiovascular events in asthmatic patients were analysed using a multiple logistic regression model.

Results A total of 206 patients with asthma were included (65.6% female; mean ± SD age 57 ± 18 years). 121 patients had allergic asthma, 98 were obese, 24 had diabetes, 65 had hypertension, 52 had dyslipidaemia and 21 had obstructive sleep apnoea. 23 patients (11%) suffered a cardiovascular event. A higher risk of cardiovascular event was observed in those patients with hypertension (OR=2.717, p=0.026), dyslipidaemia (OR=2.717, p=0.026), and chronic obstructive pulmonary disease (COPD) (OR=5.358, p=0.003). A higher risk was also observed in patients with FEV1>80% prior biologic therapy (OR=3.316, p=0.013).

In contrast, a reduced risk of a cardiovascular event was observed in those patients who had inhaled corticosteroids (OR=0.187, p=0.007) or had a BEC>150 cells/μL (OR=0.225, p=0.025).

Conclusion and Relevance Risks of cardiovascular events were increased in asthma patients with hypertension, dyslipidaemia or COPD. A lower risk of cardiovascular events was observed in patients on inhaled corticosteroids and, unexpectedly, in those with FEV1<80% and BEC>150 cells/μL. Nonetheless, these results must be interpreted with caution as the design of the current study is subject to limitations.

Conflict of Interest No conflict of interest.

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