History of Asthma From Childhood and Arterial Stiffness in Asymptomatic Young Adults: The Bogalusa Heart Study

Abstract

Asthma is related to various cardiovascular risk. Whether a history of asthma from childhood contributes to arterial stiffness in adulthood, a noninvasive surrogate for cardiovascular events, is unknown. Prospective analyses were performed among 1746 Bogalusa Heart Study participants aged 20 to 51 years with data on self-report asthma collected since childhood. Aorta-femoral pulse wave velocity (af-PWV, m/s) was repeatedly assessed among adults ≥aged 18 years. Generalized linear mixed models and generalized linear models were fitted for the repeated measurements of af-PWV and its changes between the last and the first measurements, respectively. After a median follow-up of 11.1 years, participants with a history of asthma from childhood had a higher af-PWV (6.78 versus 6.13; P=0.048) and a greater increase in af-PWV (8.99 versus 2.95; P=0.043) than those without asthma, adjusted for age, sex, race, smoking status, heart rate, body mass index, systolic blood pressure, lipids, and glycemia. In addition, we found significant interactions of asthma with body mass index and systolic blood pressure on af-PWV and its changes (P for interaction <0.01). The associations of asthma with af-PWV and its changes appeared to be stronger among participants who were overweight and obese (body mass index ≥25 kg/m²) or with prehypertension and hypertension (systolic blood pressure ≥120 mm Hg) compared with those with a normal body mass index or systolic blood pressure. Our findings indicate that a history of asthma from childhood is associated with higher af-PWV and greater increases in af-PWV, and such associations are stronger among young adults who are overweight or with elevated blood pressure.

Keywords: asthma; blood pressure; body mass index; obesity; pulse wave analysis.

Figure 1. Flowchart of the study sample

af-PWV, aorta-femoral pulse wave velocity; CVD, cardiovascular disease; #, CVD from baseline to follow-up, including arteritis, angina pectoris, angioplasty, blockage in ventricle, bypass surgery, congenital heart disease, congestive cardiac failure, enlarged left ventricle, heart murmur, heart attack, mitral valve prolapse, mitral valve stenosis, stroke, tachyarrhythmia, ventricular arrhythmia, valve replacement, and unspecified mitral disease.

Figure 2. Interaction of Asthma with BMI and SBP on aorta-femoral Pulse Wave Velocity and its longitudinal Changes

Adjusted means and 95% confident intervals of the repeated measurements of aorta-femoral pulse wave velocity (af-PWV) were calculated using generalized linear mixed models (GLMM) stratified by BMI (Figure 2a) and SBP (Figure 2c), controlled for age, gender, race, smoking status, use of antihypertensive medicine, medication for dyslipidemia, medication for glycaemia, total cholesterol, low-density lipoprotein cholesterol, fasting glucose, and heart rate as fixed effects, as well as individual ID as random effects. Adjusted means and 95% confident intervals of the 11-year changes in af-PWV (Δaf-PWV) were calculated using generalized linear models (GLM) stratified by BMI (Figure 2b) and SBP (Figure 2d), controlled for age, gender, race, smoking status, use of antihypertensive medicine, total cholesterol, low-density lipoprotein cholesterol, fasting glucose, and heart rate. β was the regression coefficient of asthma on af-PWV (the left) and its changes (the right) in stratified BMI and SBP groups in GLMMs or GLMs, followed by its p values for statistical significance. P values with FDR correction for interaction term were given by including the interaction term in the GLMMs or GLMs.