When most people think of cardiovascular disease (CVD), risk factors such as high blood pressure, high cholesterol, obesity, and diabetes likely come to mind. But mounting evidence from both basic research and clinical studies points to another common condition that may be linked to cardiovascular risk: allergic asthma. In a review paper published in Cardiovascular Nature Research By experts in cardiology, pulmonology and basic research sciences from Brigham and Women’s Hospital, researchers have developed evidence showing how allergic asthma and other related allergies may be risk factors for cardiovascular disease and how medications given to treat asthma can also affect risk. Cardiovascular disease.
Corresponding author Guo-Ping Shi, ScD, a principal investigator in the Brigham Division of Cardiovascular Medicine, said. “I’ve studied this field for more than 20 years, and the evidence we’re seeing from clinical trials as well as basic research points to allergic asthma as an important risk factor that clinicians and patients should be aware of when considering personal risks.”
Shi and his co-authors, including Peter Libby, MD, a renowned specialist in cardiovascular medicine, and Bruce Levy, MD, chief of Brigham’s division of pulmonary and critical care medicine, describe clinical studies that demonstrate the relationship between asthma and diseases such as coronary heart disease and coronary artery disease. Aorta, peripheral arterial disease, stroke, heart failure and other heart complications. They also highlight clinical studies that examined cardiovascular disease and related allergic conditions, such as allergic rhinitis (allergies to pollen and other environmental factors), atopic dermatitis (allergic eczema) and severe food and drug allergies.
“Observations from these studies suggest that allergic reactions along with asthma are also significant risk factors for CVD,” Shi said.
Shi and colleagues examined results from preclinical models and laboratory studies, which indicate certain types of inflammatory cells may accumulate in the lungs and heart and blood vessels, helping to regulate asthma and cardiovascular disease.
Both clinical and preclinical studies have indicated the common mechanisms of cardiovascular disease and asthma. The authors studied how asthma medications that act on some of these mechanisms can affect the risk of cardiovascular disease. They found that:
- Inhaling albuterol (commonly used as a “rescue inhaler” to treat severe asthma attacks) appears to reduce the risk of cardiovascular disease.
- Oral or intravenous corticosteroids (such as prednisone) appear to increase the risk of cardiovascular disease, but inhaled corticosteroids (such as fluticasone propionate and budesonide) appear to reduce the risk of cardiovascular disease.
- Leukotriene modifiers (eg, montelukast) had beneficial effects, decreasing inflammation, blood lipid levels, and cardiovascular events.
- Asthma antibodies (such as omalizumab) had mixed results, with one study finding an increased risk and another showing a reduced risk or no effect on CVD.
Mast cells are among the common white blood cells that are activated by circulating IgE in asthmatic or allergic patients. Shi and his research team report on a series of studies over the decades that support the idea that mast cells and IgE are important components of both allergic asthma and cardiovascular disease with similar mechanisms. Shi and colleagues also note that some cell types may play different roles in asthma and cardiovascular disease. For example, eosinophils – another type of white blood cell – appear to play a protective role in cardiovascular disease but contribute to allergic asthma. Better understanding the roles of different cell types and the effects of targeting them can help improve treatment, disease management, and risk assessment.
“Based on these previous studies, we can now ask: What is the next direction we need to follow? What are the weakest points we can focus on? By connecting work across basic research and clinical studies, we can begin to see the biggest visualization and think about the implications.” on patient care.”
Biological treatments are available for pediatric asthma patients
Guo-Ping Shi, Allergic asthma is a risk factor for human cardiovascular disease, Cardiovascular Nature Research (2022). DOI: 10.1038/s44161-022-00067-z. www.nature.com/articles/s44161-022-00067-z
Provided by Brigham and Women’s Hospital
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