Cardiovascular disease in asthma needs attention

Dec 17 2013

Researchers say that there should be a greater emphasis on preventing cardiovascular disease in people with asthma after finding that it was the leading cause of death in hospitalized asthma patients.

And, in contrast to those with chronic obstructive pulmonary disease (COPD), hospitalized patients with asthma died very rarely as a result of exacerbation.

The retrospective study included 2826 patients who died during admission to 13 Spanish hospitals during 4 months (January, April, July, and October) of 2008. Overall, 10.0% had COPD and 2.9% had asthma.

Among patients with asthma, 29.3% died from cardiovascular disease, 20.7% from malignancy, and 14.6% from infections. Meanwhile, patients with COPD were most likely to die from malignancy, at 26.6% (over half of which were broncho-pulmonary tumors), 25.5% died from acute respiratory failure, and 21.6% died from cardiovascular diseases. Among patients with asthma, only 6.1% died from acute respiratory failure.

The researchers also note that 59% of all fatal infections in COPD patients were pneumonia, compared with 39% of fatal infections in asthma patients; however, this difference did not reach statistical significance.

Writing in BMC Pulmonary Medicine, authors Jose Gregorio Soto-Campos (Hospital de Jerez, Cádiz, Spain) and colleagues say that there has been little previous exploration of the causes of death among asthma patients.

Despite cardiovascular disease being the most common cause of death in hospitalized asthma patients, there was no significant association between the two in multivariate analysis, which the researchers say may be due to their sample size. They suggest that future studies will be needed in large samples of patients with asthma with rigorous analysis of causes of death.

“Until such information be available, the present study could provide arguments for adopting a more proactive attitude in routine clinical practice, towards the prevention and treatment of cardiovascular diseases in patients with asthma, particularly those of advanced age,” they conclude.

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