Persistent asthma linked to plaque buildup in arteries leading to the brain

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Adults with persistent asthma may experience nearly twice as much plaque buildup in the major arteries leading to the brain as people without asthma, increasing their risk of stroke, new research suggests.

The study, published Wednesday in the Journal of the American Heart Association, also found higher levels of inflammation in people with asthma, compared to people without the condition.

Asthma is a respiratory disease that can cause difficulty breathing when the airways become inflamed, often due to allergies. This type of chronic inflammation can contribute to a buildup of plaque in the arteries. When plaque ruptures in the arteries, it can lead to a heart attack or stroke. The vessels that carry blood through the neck to the brain are called the carotid arteries.

“Many doctors and patients don’t realize that asthmatic airway inflammation can affect the arteries, so for people with persistent asthma, addressing cardiovascular disease risk factors can be very helpful,” lead study author Matthew C. Tattersall said in a news release. He is an assistant professor in the department of medicine at the University of Wisconsin at Madison.

“The presence and burden of carotid artery plaque is a strong predictor of future cardiovascular events,” he said.

Cardiovascular disease is responsible for more deaths in the US each year than all cancers and chronic lower respiratory diseases combined.

Tattersall and colleagues analyzed health data from a select group of adults who participated in the Multi-Ethnic Study of Atherosclerosis (MESA) from 2000 to 2002. The study included people from Baltimore; Chicago; the city of New York; St Paul, Minnesota; Los Angeles County, California; and Forsyth County, North Carolina. The 5,029 participants included in the analysis averaged 61 years of age and were free of cardiovascular disease at the time of enrollment, but had a number of risk factors for cardiovascular disease, including obesity, smoking, high cholesterol, high blood pressure or diabetes.

Participants were categorized as having intermittent, persistent, or no asthma. Asthma was considered persistent if daily medication was required to control symptoms. Ultrasound measured plaque in the carotid arteries on both sides of the neck, and blood tests measured inflammation.

Plaque was present in the carotid arteries of 67% of 109 people with persistent asthma, 49.5% of 388 with intermittent asthma, and 50.5% of 4,532 people without asthma. Participants with persistent asthma had almost twice as much plaque as participants with intermittent or no asthma. Compared to participants without asthma, those with persistent asthma also had more inflammation.

“This analysis tells us that the increased risk of carotid artery plaques in people with persistent asthma is likely influenced by multiple factors,” Tattersall said. “Participants with persistent asthma had elevated levels of inflammation in their blood even though their asthma was treated with medications, which highlights the inflammatory features of asthma. We know that higher levels of inflammation lead to negative effects on the cardiovascular system.”

Other inflammatory conditions, such as lupus and arthritis, are included as risk factors in the 2019 AHA guidelines for the primary prevention of cardiovascular disease. This study contributes to the understanding of how inflammatory diseases can affect cardiovascular health.

“Addressing cardiovascular risk factors through lifestyle and behavior modifications can be a powerful preventative tool for patients with more severe forms of asthma,” Tattersall said.

If you have any questions or comments about this story from the American Heart Association News, please email [email protected].

Persistent asthma linked to plaque buildup in arteries leading to the brain

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