The association between allergy skin testing, atopic respiratory conditions, and stroke mortality in middle-aged and elderly adults.
BACKGROUND
A history of atopic respiratory conditions has been linked to an increased risk of stroke. What remains unclear is whether positive allergy skin testing is associated with an increased risk of stroke. The primary goal of this study was to determine whether positive allergy skin testing is associated with an increased risk of fatal stroke. A secondary goal is to determine whether having both positive allergy skin testing and an atopic respiratory condition is associated with a particularly high risk of stroke death.


METHODS
An analysis was performed of the National Health and Nutrition Examination Survey II Mortality Cohort.


RESULTS
Controlling for age, gender, race, alcohol use, smoking status, diabetes, hypertension, and body mass index, patients with positive allergy skin testing had a hazard ratio for stroke mortality of 1.56 (95% CI, 1.01-2.40) versus those without positive allergy testing. Patients with both positive allergy testing and an atopic respiratory condition had a hazard ratio for stroke mortality of 2.31 (95% CI, 1.13-4.73).


CONCLUSIONS
Individuals with both positive allergy skin testing and an atopic respiratory condition have more than a 2-fold increased risk of fatal stroke. This novel risk factor has substantial implications for a large segment of the population not previously considered at risk.
Matheson
Eric M
EM
Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. matheson@musc.edu
Mainous
Arch G
AG
Carnemolla
Mark A
MA
D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012130:Respiratory Hypersensitivity / Q000150:complications*; D012882:Skin Tests; D020521:Stroke / Q000209:etiology* / Q000401:mortality; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology