Asthma, asthma control and risk of ischemic stroke: The HUNT study

Background: Asthma, a chronic inflammatory airway disease, shares common pathophysiological mechanisms with ischemic stroke. The aim of the study is to assess the association between asthma, levels of asthma control and ischemic stroke risk in men and women and by smoking habits. Methods: This prosp...

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Main Authors: Aivaras Cepelis, Ben M. Brumpton, Lars E. Laugsand, Arnulf Langhammer, Imre Janszky, Linn B. Strand
Format: Article
Language:English
Published: Elsevier 2020-11-01
Series:Respiratory Medicine: X
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2590143519300144
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spelling doaj-7cf3cff5c6a741f2aa135ecde0c6b80b2020-12-15T04:10:50ZengElsevierRespiratory Medicine: X2590-14352020-11-012100013Asthma, asthma control and risk of ischemic stroke: The HUNT studyAivaras Cepelis0Ben M. Brumpton1Lars E. Laugsand2Arnulf Langhammer3Imre Janszky4Linn B. Strand5Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Corresponding author.Clinic for Thoracic and Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UKDepartment of Emergency Medicine, St. Olavs Hospital, Trondheim, NorwayDepartment of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology, Medical School, University of Pécs, Pécs, HungaryDepartment of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU, Norwegian University of Science and Technology, Trondheim, NorwayBackground: Asthma, a chronic inflammatory airway disease, shares common pathophysiological mechanisms with ischemic stroke. The aim of the study is to assess the association between asthma, levels of asthma control and ischemic stroke risk in men and women and by smoking habits. Methods: This prospective population-based cohort study utilized data on 58 712 adults from HUNT Study in Norway free from stroke. Self-reported asthma was categorized as ever asthma, non-active asthma and active asthma (i.e., being on asthma medication within 12 months of the baseline). Asthma control was defined according to the Global Initiative for Asthma questionnaire and was categorized into controlled and not controlled asthma. Stroke was ascertained by linking HUNT data with Nord-Trøndelag hospital records and the Norwegian Patient Registry. Results: During a mean follow-up of 17.3 ± 5.3 years, 2619 participants (4.5%) had a first stroke. Not controlled asthma was associated with a modest increased risk of stroke (adjusted HR 1.34, 95%CI 1.03–1.73). Subgroup analyses revealed that the respective association was stronger among those with history of smoking (HR 1.48, 95%CI 1.10–2.00) and males (HR 1.55, 95%CI 1.12–2.16) while absent in non-smokers (HR 1.02, 95%CI 0.61–1.70) and females (HR 1.05, 95%CI 0.69–1.60). Likewise, active asthma was associated with similar increased stroke risk among smokers and males and absent in non-smokers and females. Conclusions: Symptomatic and active asthma was associated with a modest increased relative risk for ischemic stroke in smokers and males. Future studies should clarify the difference in risks and mechanisms between different phenotypes of asthma.http://www.sciencedirect.com/science/article/pii/S2590143519300144AsthmaAsthma controlStroke
collection DOAJ
language English
format Article
sources DOAJ
author Aivaras Cepelis
Ben M. Brumpton
Lars E. Laugsand
Arnulf Langhammer
Imre Janszky
Linn B. Strand
spellingShingle Aivaras Cepelis
Ben M. Brumpton
Lars E. Laugsand
Arnulf Langhammer
Imre Janszky
Linn B. Strand
Asthma, asthma control and risk of ischemic stroke: The HUNT study
Respiratory Medicine: X
Asthma
Asthma control
Stroke
author_facet Aivaras Cepelis
Ben M. Brumpton
Lars E. Laugsand
Arnulf Langhammer
Imre Janszky
Linn B. Strand
author_sort Aivaras Cepelis
title Asthma, asthma control and risk of ischemic stroke: The HUNT study
title_short Asthma, asthma control and risk of ischemic stroke: The HUNT study
title_full Asthma, asthma control and risk of ischemic stroke: The HUNT study
title_fullStr Asthma, asthma control and risk of ischemic stroke: The HUNT study
title_full_unstemmed Asthma, asthma control and risk of ischemic stroke: The HUNT study
title_sort asthma, asthma control and risk of ischemic stroke: the hunt study
publisher Elsevier
series Respiratory Medicine: X
issn 2590-1435
publishDate 2020-11-01
description Background: Asthma, a chronic inflammatory airway disease, shares common pathophysiological mechanisms with ischemic stroke. The aim of the study is to assess the association between asthma, levels of asthma control and ischemic stroke risk in men and women and by smoking habits. Methods: This prospective population-based cohort study utilized data on 58 712 adults from HUNT Study in Norway free from stroke. Self-reported asthma was categorized as ever asthma, non-active asthma and active asthma (i.e., being on asthma medication within 12 months of the baseline). Asthma control was defined according to the Global Initiative for Asthma questionnaire and was categorized into controlled and not controlled asthma. Stroke was ascertained by linking HUNT data with Nord-Trøndelag hospital records and the Norwegian Patient Registry. Results: During a mean follow-up of 17.3 ± 5.3 years, 2619 participants (4.5%) had a first stroke. Not controlled asthma was associated with a modest increased risk of stroke (adjusted HR 1.34, 95%CI 1.03–1.73). Subgroup analyses revealed that the respective association was stronger among those with history of smoking (HR 1.48, 95%CI 1.10–2.00) and males (HR 1.55, 95%CI 1.12–2.16) while absent in non-smokers (HR 1.02, 95%CI 0.61–1.70) and females (HR 1.05, 95%CI 0.69–1.60). Likewise, active asthma was associated with similar increased stroke risk among smokers and males and absent in non-smokers and females. Conclusions: Symptomatic and active asthma was associated with a modest increased relative risk for ischemic stroke in smokers and males. Future studies should clarify the difference in risks and mechanisms between different phenotypes of asthma.
topic Asthma
Asthma control
Stroke
url http://www.sciencedirect.com/science/article/pii/S2590143519300144
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