Late‐Onset Asthma Predicts Cardiovascular Disease Events: The Wisconsin Sleep Cohort

BACKGROUND: Asthma is a heterogeneous syndrome with different clinical subtypes that is associated with an increased risk for cardiovascular disease (CVD). We hypothesized that the late‐onset subtype of asthma is associated with a higher risk of incident CVD. METHODS AND RESULTS: Participants from the Wisconsin Sleep Cohort free of CVD at baseline were followed for a mean (SD) of 13.9 (5.9) years for development of CVD (myocardial infarction, angina, stroke, coronary revascularization, heart failure, or CVD death). Late‐onset asthma was defined as physician‐diagnosed asthma at age ≥18 years. Multivariable Cox regression models adjusted for age, sex, and CVD risk factors were used to assess associations of late‐onset asthma and incident CVD. The 1269 participants were 47.3 (8.0) years old; 166 participants had asthma (111 late‐onset, 55 early‐onset). Participants with late‐onset asthma compared to nonasthmatics were more likely to be female (67% versus 44%) and to have a higher body‐mass index (32.2 versus 29.4 kg/m(2)) (P<0.05). Mean age of asthma diagnosis in the late‐onset group was 39.5 (9.6) years versus 8.9 (5.7) years in the early‐onset group (P<0.0001). Late‐onset asthmatics had a higher adjusted risk of incident CVD than nonasthmatics (hazard ratio 1.57, 95% CI 1.01–2.45, P=0.045). There was no interaction between body‐mass index and age of asthma diagnosis on incident CVD (P=0.83). CONCLUSIONS: In a large cohort study of adults followed prospectively for over a decade, late‐onset asthmatics had an increased risk of incident CVD events that persisted after adjustment for age, sex, and CVD risk factors.