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  • Is having asthma associated with an increased risk of dying from cardiovascular disease? A prospective cohort study of 446 346 Taiwanese adults

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Epidemiology
Research
Is having asthma associated with an increased risk of dying from cardiovascular disease? A prospective cohort study of 446 346 Taiwanese adults
  1. Linn Beate Strand1,
  2. Min Kuang Tsai2,3,4,
  3. Chi Pang Wen3,4,
  4. Shu-Sen Chang5,
  5. Ben M Brumpton6,7,8
  1. 1 Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
  2. 2 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
  3. 3 China Medical University Hospital, Taichung, Taiwan
  4. 4 Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
  5. 5 Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei City, Taiwan
  6. 6 Department of Thoracic and Occupational Medicine, St. Olavs Hospital, Trondheim, Norway
  7. 7 K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
  8. 8 MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
  1. Correspondence to Dr Chi Pang Wen; cwengood{at}nhri.org.tw and Dr Shu-Sen Chang; shusenchang{at}ntu.edu.tw

Abstract

Objectives A significant proportion of cardiovascular disease (CVD) cannot be explained by well-known risk factors such as high cholesterol, hypertension and diabetes. One potential novel risk factor for CVD is asthma. We aimed to investigate the association between asthma and mortality due to CVD.

Design Prospective cohort study.

Setting A large health check-up programme from 1994 to 2011 in Taipei, Taiwan.

Participants 446 346 Taiwanese adults. Each participant answered questions regarding asthma history (yes/no) and current daily use of asthma medications (yes/no). Active asthma was defined as those using current daily medications for asthma.

Outcomes The participants were followed for mortality from CVD, coronary heart disease (CHD) and stroke obtained through linkage to the cause-of-death register until 31 December 2011.

Results We found an increased risk of dying from CVD in individuals with active asthma (adjusted HR (aHR) 1.32, 95% CI 1.08 to 1.62). The risk of death from CHD or stroke was increased in a similar manner (aHR 1.16, 95% CI 0.78 to 1.73 and aHR 1.23, 95% CI 0.86 to 1.74, respectively) although the HR estimates were less precise than that of CVD. For deaths from CVD, CHD and stroke, we found stronger associations with active asthma than non-active asthma, and for CVD and stroke stronger associations in men than women.

Conclusion Our study suggests that asthma, particularly active asthma, may be associated with adverse cardiovascular consequences.

  • asthma
  • cardiology
  • epidemiology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-019992

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    Footnotes

    • Contributors LBS wrote the analysis plan and wrote the first draft of the manuscript. MKT did the data analysis. C-PW supervised the work and reviewed the manuscript. S-SC helped supervise the work, reviewed the manuscript and coordinated the collaboration between the researchers. BMB designed the study, helped write the analysis plan, wrote the methods section of the manuscript and reviewed the manuscript. All authors confirmed that they reviewed and approved the final version of the manuscript.

    • Funding This work was supported by funding for the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology awarded to LBS and BMB. BMB works in a research unit funded by Stiftelsen Kristian Gerhard Jebsen; Faculty of Medicine and Health Sciences, NTNU; The Liaison Committee for education, research and innovation in Central Norway and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The China Medical University Hospital Ethics Committee has approved the research protocol. The study was approved by the National Health Research Institutes, Taiwan and the MJ Health Management Institution.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.