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. 2021 Jan 14;11(1):1329.
doi: 10.1038/s41598-020-79264-4.

Adults with current asthma but not former asthma have higher all-cause and cardiovascular mortality: a population-based prospective cohort study

Xumei He  1 , GeSheng Cheng  1 , Lu He  1 , Bing Liao  2 , YaJuan Du  1 , Xuegang Xie  1 , Songlin Zhang  1 , Gang Li  3 , Yafeng Wang  4 , YuShun Zhang  5
Affiliations

Adults with current asthma but not former asthma have higher all-cause and cardiovascular mortality: a population-based prospective cohort study

Xumei He et al. Sci Rep. .

Abstract

Higher mortality in asthmatics has been shown previously. However, evidence on different asthma phenotypes on long-term mortality risk is limited. The aim was to evaluate the impact of asthma phenotypes on mortality in general population. Data from the National Health and Nutrition Examination Survey from 2001-2002 to 2013-2014 linked mortality files through December 31, 2015, were used (N = 37,015). Cox proportional hazards regression was used to estimate the risk of all-cause and cause-specific mortality adjusting for sociodemographic characteristics, smoking, body mass index, and chronic conditions. During the mean follow-up time of 7.5 years, 4326 participants died from a variety of causes. Current asthma, but not former asthma was associated with increased all-cause mortality (current asthma: HR = 1.37; 95% CI 1.20-1.58; Former asthma: HR = 0.93; 95% CI 0.73-1.18); as well as mortality from cardiovascular disease (HRCurrent = 1.41; 95% CI 1.08-1.85) and chronic lower respiratory diseases (HRCurrent = 3.17; 95% CI 1.96-5.14). In addition, we found that the HR for cardiovascular disease (CVD) mortality was slightly greater in people with childhood-onset asthma than those with adult-onset asthma. The HR for chronic lower respiratory diseases (CLRD) mortality was greater in people with adult-onset asthma than those with childhood-onset asthma. However, the differences were not statistically significant. Our study suggested that current asthma but not former asthma was associated with increased all-cause, CLRD and CVD mortality. Future well-designed studies with larger sample are required to demonstrate the association and clarify the potential mechanisms involved.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The association between asthma and all-cause, CVD and cancer and cause-specific mortality. CI confidence interval, CVD cardiovascular disease, HR hazard ratios. Multivariable models were adjusted for age, sex, race, education, income, smoking status, body mass index, diabetes, arthritis, coronary heart disease, stroke and cancer.
Figure 2
Figure 2
HRs for all-cause and cause-specific mortality among non-asthmatics, former asthmatics and current asthmatics. CI confidence interval, CVD cardiovascular disease, HR hazard ratios. Multivariable models were adjusted for age, sex, race, education, income, smoking status, body mass index, diabetes, arthritis, coronary heart disease, stroke and cancer.
Figure 3
Figure 3
Subgroup analysis of the association of asthma with all-cause mortality (Current asthma vs. Non-asthma). CI confidence interval, CVD cardiovascular disease, HR hazard ratios. Multivariable models were adjusted for age, sex, race, education, income, smoking status, body mass index, diabetes, arthritis, coronary heart disease, stroke and cancer.
Figure 4
Figure 4
Risk of all-cause, CVD and CLRD mortality according to presence of asthma and its onset. CI confidence interval, CLRD, chronic lower respiratory diseases, CVD cardiovascular disease, HR hazard ratios. Multivariable models were adjusted for age, sex, race, education, income, smoking status, body mass index, diabetes, arthritis, coronary heart disease, stroke and cancer.
Figure 5
Figure 5
Value of the joint minimum strength of association on the risk ratio scale that an unmeasured confounder must have with the exposure and the outcome to fully explain away an observed current asthma—all-cause mortality HR.
See this image and copyright information in PMC

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