Asthma, inflammation could increase the risk of heart attack and stroke
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When we talk about inflammation as a driver of atherosclerosis, we often think only of the arteries. And we forget that if there are chronic inflammatory pictures in other districts in which this “fuel” of the arterial obstruction processes is not eliminated, the heart and brain are at risk. A research coordinated by Matthew C. Tattersallprofessor in the medical department of the University of Wisconsin at Madison, published in Journal of the American Heart Association.
The survey takes into consideration the volume of blockages that can form along the carotid arteries, basic sources of blood supply to the brain, showing how in those suffering from persistent asthma the size of these “blocks” to the circulation tend to increase over time than those with less severe asthma or no respiratory symptoms.
More than 5000 people follow
The data considered in the publication comes from the study Multi-Ethnic Study of Atherosclerosis (MESA) conducted on just under 7,000 adults recruited in 2000 at six different locations in the US. All subjects, at the time of enrolment, had no problems related to cardiovascular pathologies. In particular, in this specific survey, information relating to 5,029 adults, with an average age of 61 years, who had underlying risk factors for cardiovascular disease and who had ultrasound checks of the carotids were considered.
These included subjects with persistent asthma (for which medications were prescribed every day), intermittent asthma (less frequent treatments. At the start of the MESA study, all participants had an ultrasound scan of the left and right carotid arteries to identify possible atherosclerotic plaques.In addition, markers of inflammation, such as Interleukin-6 (IL-6) and C-reactive protein (CRP), were measured in the blood.
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Vessels at risk for those with more severe asthma
The study demonstrated an initial worrying fact: in those who suffered from persistent asthmacarotid artery plaque was observed in over two out of three people, compared with 49.5% of subjects who showed plaque and suffered from intermittent asthma and a similar percentage in non-asthmatics. Not only that: the plaques were on average two in subjects with more severe respiratory disease and one in the others.
In the end, taking away the weight of other potential cardiovascular risk factors, those suffering from persistent asthma were almost twice as likely to have a carotid artery plaque compared to those without asthma. The values of the inflammatory parameters, potentially also involved in the pathological process affecting the arterial wall, were also higher in asthmatics. As Tattersall notes, in short, “the participants with persistent asthma had elevated levels of inflammation in the blood, even if the pathology was treated with drugs, which highlights the inflammatory characteristics of asthma”.
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The multidisciplinary approach is essential
“This study and its results make the multidisciplinary approach that must be the basis of the monitoring over time of the person with asthma even more significant – he comments George Walter Canonica, Professor of Respiratory Medicine at Humanitas University in Milan. The person must be followed as a whole, in integrated teams that see cardiologist and pulmonologist work together, also because inflammation is always a factor present in respiratory pathology but as these data show, it can act on the entire organism”.
According to the experts, it is also important to evaluate the potential impact of the therapy over time on cardiovascular risk factors. “We know that especially in thesevere asthma the metabolic picture can be complicated by overweight and obesity and that over time a treatment with cortisone derivatives can favor weight gain and therefore have a negative impact on the patient’s risk profile – is Canonica’s opinion. This is why it is necessary to focus on targeted treatments, case by case, also considering the importance of adherence to therapy for respiratory disease as a key factor for the prevention of complications affecting the whole organism”.
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