title: Asthma and asthma severity among African American adults in the Jackson Heart Study.
abstract: The aims of this study were to investigate the baseline prevalence of and risk factors associated with asthma, classify asthma severity, and describe medication use in a population-based sample of African American men and women 21 to 84 years of age from the Jackson Heart Study (JHS). Participants provided responses to respiratory and medical history questions and a medication inventory and underwent spirometry and other clinical examinations. These data were used to examine the extent to which novel and traditional risk factors were associated with asthma. Of the 4,098 participants included in this analysis, 9.4% reported lifetime asthma (5.7% current, 3.7% former), and current asthma was higher in women (6.8%) than in men (3.8%). An additional 9.8% reported an attack of wheeze with shortness of breath or non-doctor confirmed asthma (i.e., "probable" asthma). The mean forced expiratory volume in 1 second (FEV(1))% predicted was lower in those reporting current asthma (women: 83.7 +/- 18.0; men: 75.2 +/- 16.8) compared to those not reporting asthma (women: 95.6 +/- 16.7; men: 91.7 +/- 16.0). Current and probable asthma was associated with lower serum cortisol levels and hypertension medication use, along with traditional risk factors (i.e., lower socio-economic status, higher global stress scores, obesity, and fair to poor perceived general health). Severe asthma was low among participants reporting current (9.8%), former (3.3%), and probable (4.9%) asthma. Asthma medication use was reported by nearly 60% of the participants reporting current asthma. Asthma in African American adults is associated with decreased serum cortisol, hypertension medication use, and considerable lung function impairment compared to those who did not report asthma. The prevalence of asthma in the JHS is lower than state and national estimates, although the estimates are not directly comparable. Furthermore, asthma is drastically underdiagnosed in this population.
authors.affiliation: Jackson State University, Jackson Heart Study, Coordinating Center, USA.
authors.forename: DeMarc A
authors.initials: DA
authors.lastname: Hickson
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Wilhite
authors.forename: Marcy F
authors.initials: MF
authors.lastname: Petrini
authors.forename: Wendy B
authors.initials: WB
authors.lastname: White
authors.forename: Cecil
authors.initials: C
authors.lastname: Burchfiel
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D055815:Young Adult