FEBRUARY 4, 2020
People with persistent asthma could be at 1.5
times higher risk of developing a heart rhythm disorder called atrial
fibrillation than those without asthma, new research shows.
The study used data collected on 6,615 people
in six areas around the country who were followed for nearly 13 years. When the
study started, none of the participants had heart
disease. Researchers concluded that the 150 participants with
persistent asthma—those who required medication daily to
control their condition—were more likely to be diagnosed with AFib than those
without asthma.
Inflammation is a risk factor for both asthma
and AFib, and the study found people with persistent asthma had the highest
levels of inflammation. But the research also suggests
there may be more than inflammation connecting asthma to an irregular
heartbeat.
"We initially suspected that the link
between asthma and atrial fibrillation may
be explained by high levels of common inflammation markers in the blood at the
baseline of the study," said study author Dr. Matthew Tattersall, an
assistant professor of cardiovascular medicine at the University of Wisconsin
in Madison. "These inflammation markers are higher in asthmatics and
independently predict atrial fibrillation."
But when he and his colleagues adjusted for
those inflammation blood markers, the relationship between asthma and AFib did
not significantly change, Tattersall said. That led them to believe "there
may be specific unique patterns of inflammation not identified or even other
non-inflammatory pathways that may be driving an increased risk."
Previous studies done in other countries also
have found a link between asthma and AFib. One study in Norway, with 54,567
adults, found having asthma was associated with a 38% increased risk of AFib.
The new study is the first in the U.S.,
according to study authors, and the first to include a racially diverse group
of people; 27% of participants were African American, 12% Chinese and 22%
Hispanic. The research was published Tuesday in the American Heart Association
journal Circulation: Arrhythmia and Electrophysiology.
At least 5.2 million Americans are living with
atrial fibrillation. The condition is marked by a quivering or irregular
heartbeat called an arrhythmia. It can cause heart failure
and other heart-related complications, as well as blood
clots. If a clot leaves the heart and travels to the brain, it can
cause a stroke.
People with untreated AFib are nearly five
times more likely to have a stroke than those who do not have this heart
problem.
Over 25 million Americans have asthma, a
chronic disease caused by inflammation in the bronchial tubes, or airways, in
the lungs. People with persistent asthma are prescribed daily
controller medications to keep their airways from tightening up and prevent
coughing, wheezing, shortness of breath or chest tightness.
Patients and doctors need to know about the
association between asthma and AFib, said Dr. Marc Miller, a cardiac
electrophysiologist and an assistant professor of cardiology at Icahn School of
Medicine at Mount Sinai in New York City. But he cautioned the study doesn't
show asthma is causing AFib.
"The theory is they both have a common
origin—systemic inflammation," said Miller, who was not involved with the
study. "But we don't know if that is the reason asthma patients get atrial
fibrillation or if it's the therapies being used to treat the asthma that are
inducing the atrial fibrillation."
Tattersall said the connection between the two
conditions suggests doctors should be talking to their asthma patients about
the importance of heart-healthy behaviors, such as exercise, maintaining a
healthy weight and eating a heart-healthy, low-sodium diet.
"Being aware there is this association
means we need to help patients focus on these primary prevention things we know
we should be doing but that are often the hardest things to do,"
Tattersall said. "But they can help with asthma and they can also reduce
risk for atrial fibrillation."
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