title: Asthma is associated with cardiovascular disease in a representative population sample.
abstract: CONCLUSIONS
  
  
  
  BACKGROUND
  People with asthma may have an increased risk of cardiovascular disease (CVD) and metabolic disorders due to the direct involvement of common inflammatory mediators in the pathogenesis of CVD and insulin resistance. The aim of this study was to determine whether asthma was associated with an increased prevalence of CVD/stroke, and diabetes in a cross-sectional population study and whether the relationship was modified by obesity.
  
  
  METHODS
  The North West Adelaide Health Study (NWAHS) (n = 4060, age ≥18 years) clinical assessment included spirometry, anthropometry, blood pressure, fasting lipids, glucose and HbA1c. Questionnaires assessed doctor diagnosed asthma, diabetes, CVD (myocardial infarction, angina)/stroke, smoking status, and demographics. Asthma was identified by self-report or significant bronchodilator reversibility of lung function.
  
  
  RESULTS
  After adjustment for known risk factors and confounders, asthma was not associated with diabetes (odds ratio (OR) = 1.06, 95% confidence interval (CI): 0.45-2.49, p = .91) yet remained positively associated with CVD/stroke (OR = 1.82, 95% CI: 1.20-2.73, p < 0.01) independent of the level of BMI (p for interaction between asthma and BMI = .22), smoking and lung function. Asthma was not positively associated with CVD risk factors or the metabolic syndrome.
  
  
  CONCLUSIONS
  In a representative population sample, asthma was associated with CVD/stroke after adjustment for traditional risk factors and lung function. Asthma may lead to CVD events via pathways unrelated to traditional risk factors and this requires further investigation. No significant effect modification by BMI was observed in relation to CVD, or diabetes.
authors.affiliation: The Health Observatory, Department of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, South Australia 5011, Australia. Electronic address:sarah.appleton@adelaide.edu.au.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Appleton
authors.affiliation: The Health Observatory, Department of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, South Australia 5011, Australia.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Ruffin
authors.affiliation: The Health Observatory, Department of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, South Australia 5011, Australia.
authors.forename: David H
authors.initials: DH
authors.lastname: Wilson
authors.affiliation: The Health Observatory, Department of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, South Australia 5011, Australia.
authors.forename: Anne W
authors.initials: AW
authors.lastname: Taylor
authors.affiliation: The Health Observatory, Department of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, South Australia 5011, Australia.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Adams