title: Asthma predicts cardiovascular disease events: the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  To identify and characterize an association between persistent asthma and cardiovascular disease (CVD) risk in the Multi-Ethnic Study of Atherosclerosis (MESA).
  
  
  RESULTS
  MESA is a longitudinal prospective study of an ethnically diverse cohort of individuals free of known CVD at its inception. The presence and severity of asthma were assessed in the MESA at examination 1. Persistent asthma was defined as asthmatics using controller medications (inhaled corticosteroids, leukotriene inhibitors, and oral corticosteroids) and intermittent asthma as asthmatics not using controller medications. Participants were followed up for a mean (SD) of 9.1 (2.8) years for development of incident CVD (coronary death, myocardial infarction, angina, stroke, and CVD death). Multivariable Cox regression models were used to assess associations of asthma and CVD. The 6792 participants were 62.2 (SD, 10.2) years old: 47% men (28% black, 22% Hispanic, and 12% Chinese). Persistent asthmatics (n=156), compared with intermittent (n=511) and nonasthmatics (n=6125), respectively, had higher C-reactive protein (1.2 [1.2] versus 0.9 [1.2] versus 0.6 [1.2] mg/L) and fibrinogen (379 [88] versus 356 [80] versus 345 [73] mg/dL) levels. Persistent asthmatics had the lowest unadjusted CVD-free survival rate of 84.1%, 95% confidence interval (78.9%-90.3%) compared with intermittent asthmatics 91.1% (88.5%-93.8%) and nonasthmatics 90.2% (89.4%-91%). Persistent asthmatics had greater risk of CVD events than nonasthmatics (hazard ratio [95% confidence interval], 1.6 [1.01-2.5]; P=0.040]), even after adjustment for age, sex, race, CVD risk factors, and antihypertensive and lipid medication use.
  
  
  CONCLUSIONS
  In this large multiethnic cohort, persistent asthmatics had a higher CVD event rate than nonasthmatics.
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Tattersall
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Mengye
authors.initials: M
authors.lastname: Guo
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Korcarz
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Adam D
authors.initials: AD
authors.lastname: Gepner
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Kiang J
authors.initials: KJ
authors.lastname: Liu
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Donohue
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McClelland
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.).
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Delaney
authors.affiliation: From the Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison (M.C.T., C.E.K., A.D.G., J.H.S.); Department of Biostatistics (M.G.) and Department of Epidemiology (J.D.K., J.A.D.), University of Washington School of Public Health, Seattle; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University and Mailman School of Public Health, Columbia University, New York, NY (R.G.B.); and Division of Pulmonary, Department of Medicine, Allergy and Critical Care Medicine Columbia University, New York, NY (K.M.D.). jhs@medicine.wisc.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D000368:Aged; D001249:Asthma / Q000150:complications* / Q000208:ethnology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000150:complications* / Q000208:ethnology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: asthma; atherosclerosis; epidemiology; risk factors