CHICAGO, ILLINOIS – A new study has revealed that patients with persistent asthma had a 60 percent higher risk of cardiovascular events, including myocardial infarction (heart attack), resuscitated cardiac arrest, angina (chest pain), stroke, and cardiovascular/stroke death when compared with individuals without asthma.
Moreover, the study showed that patients with persistent asthma had significantly elevated age-adjusted levels of two markers of inflammation (C-reactive protein or CRP and fibrinogen), a finding that suggests a link between the inflammatory processes in asthma and cardiovascular disease.
Warning to asthma patients, physicians
“The most important message of our research is that patients with asthma should be aware that they are at increased risk for heart and vascular disease,” said senior investigator Dr. James Stein of the University of Wisconsin-Madison. “Although we are not certain of the mechanism involved, asthma patients and their physicians should pay close attention to traditional risk factors such as blood pressure, cholesterol, smoking, and obesity.”
Results of the study, which is an analysis from the Multi-Ethnic Study of Atherosclerosis (MESA), were presented at the American Heart Association (AHA) 2014 Scientific Sessions held from November 15-19, 2014 in Chicago, Illinois.
The analysis covered over a 9-year follow-up period and involved 6,792 individuals participating in MESA. It included patients from various ethnicities, such as Caucasians, Chinese, African-Americans, and Hispanics. There was essentially an equal number of male and female subjects whose average age was 62 years.
Of the cohort, 156 had persistent asthma (required regular controller medications) while 511 had intermittent asthma (not taking controller medication). The majority of patients in the cohort (6,125) had no asthma.
Increasing burden of asthma in the Philippines
Asthma is a condition in which the passageways for air into and out of the lungs narrow and swell and produce extra mucus, resulting in difficulty in breathing, coughing, wheezing and shortness of breath. Inflammation plays a central role in the pathophysiology of asthma, according to the Philippine College of Chest Physicians (PCCP). Experts believe that asthma is caused by a combination of environmental and genetic factors.[pq]According to the Department of Health (DOH), asthma and cardiovascular diseases are among the top 10 leading causes of death in the Philippines.[/pq]
Asthma is highly prevalent in urban areas of the Philippines, with 27 percent to 33 percent of children and 17 percent to 22 percent of adults with definite or probable asthma, according to the Philippine Consensus Report on Asthma 2009 published by the PCCP.
“The prevalence of asthma in the country appears to be increasing. Evidence suggests that asthma cases increase as communities adopt western lifestyles and become more urbanized,” the report noted.
The report also pointed out that deaths due to asthma do not appear to correlate well with the prevalence of the disease. “Many of the deaths caused by asthma are preventable, and thought to be due to suboptimal long-term medical care and delay in obtaining help during the final asthma attack.”[pq]Results of the Asthma Insights and Reality in the Asia Pacific Region (AIRIAP) suggest that there are almost 11 million Filipinos suffering from asthma.[/pq]
The survey was conducted from September to December 2000 in urban centers in China, Hong Kong, Korea, Malaysia, the Philippines, Singapore, Taiwan and Vietnam.
A total of 3,200 people (400 from each nation) with asthma participated in the survey, which aimed to determine the burden of asthma and the level of unmet needs for the disease. Of the total number of Filipinos who participated in the survey, only 2 percent had controlled asthma while 49 percent had uncontrolled asthma.
Importance of patient education
The Philippine Consensus Report on Asthma underscored the importance of patient education and good doctor-patient relationship in the management and control of asthma. “The aim of patient education is guided self-management, particularly in taking the right treatments, adopting a healthy lifestyle and avoiding asthma triggers.”
The report also urged healthcare professionals to be good communicators, which can result to better outcomes, including increased patient satisfaction, better health, and reduced use of healthcare services. Moreover, such benefits can be achieved without any increase in consultation times.
– Eric Michael Santos, Medical Observer
6. Philippine Consensus Report on Asthma 2009. https://dl.dropboxusercontent.com/u/38069167/CPGs/PHILIPPINES%20Asthma%20Consensus%20Guidelines%202009.pdf