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Increased stroke risk among adult asthmatic patients.
Eur J Clin Invest. 2014 Nov; 44(11):1025-33.EJ

Abstract

BACKGROUND

We conducted a nationwide population-based cohort study to investigate the effects of asthma on the risk of stroke development in an Asian population.

MATERIALS AND METHODS

Newly diagnosed asthmatic patients aged ≥ 18 years were identified, and asthma-free controls were randomly selected from the general population and frequency matched according to age, sex and index year using records obtained from the National Health Insurance Research Database between 2000 and 2010. Both cohorts were followed up until the end of 2011 to measure the incidence of stroke. The risk of stroke was analysed using Cox proportional hazard regression models, including factors such as sex, age and comorbidities.

RESULTS

We followed the asthmatic patients for 104 697 person-years and followed the nonasthmatic people for 426 729 person-years. The incidence density rate of stroke increased in all of the groups of asthmatic patients compared with that of the controls when stratified according to sex, age and comorbidities. The hazard ratio (HR) of stroke was 1·37-fold greater for the asthmatic cohort, compared with that for the nonasthmatic cohort, after adjusting for sex, age and comorbidities. The adjusted HR of developing stroke substantially increased with older age and the increased frequency of asthmatic exacerbation and hospitalization. The patients receiving beta-2 agonists as a treatment exhibited a significantly greater risk of stroke compared with the patients receiving only inhaled corticosteroids, after adjusting for covariates.

CONCLUSION

Asthma may be an independent risk factor for stroke, and its severity exhibits a dose response of stroke development.

Authors+Show Affiliations

Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25207756

Citation

Chung, Wei-Sheng, et al. "Increased Stroke Risk Among Adult Asthmatic Patients." European Journal of Clinical Investigation, vol. 44, no. 11, 2014, pp. 1025-33.
Chung WS, Lin CL, Chen YF, et al. Increased stroke risk among adult asthmatic patients. Eur J Clin Invest. 2014;44(11):1025-33.
Chung, W. S., Lin, C. L., Chen, Y. F., Ho, F. M., Hsu, W. H., & Kao, C. H. (2014). Increased stroke risk among adult asthmatic patients. European Journal of Clinical Investigation, 44(11), 1025-33. https://doi.org/10.1111/eci.12336
Chung WS, et al. Increased Stroke Risk Among Adult Asthmatic Patients. Eur J Clin Invest. 2014;44(11):1025-33. PubMed PMID: 25207756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased stroke risk among adult asthmatic patients. AU - Chung,Wei-Sheng, AU - Lin,Cheng-Li, AU - Chen,Yung-Fu, AU - Ho,Feng-Ming, AU - Hsu,Wu-Huei, AU - Kao,Chia-Hung, Y1 - 2014/10/01/ PY - 2014/05/09/received PY - 2014/09/07/accepted PY - 2014/9/11/entrez PY - 2014/9/11/pubmed PY - 2015/6/30/medline KW - Adult asthma KW - beta-2 agonists KW - population-based cohort study KW - stroke SP - 1025 EP - 33 JF - European journal of clinical investigation JO - Eur J Clin Invest VL - 44 IS - 11 N2 - BACKGROUND: We conducted a nationwide population-based cohort study to investigate the effects of asthma on the risk of stroke development in an Asian population. MATERIALS AND METHODS: Newly diagnosed asthmatic patients aged ≥ 18 years were identified, and asthma-free controls were randomly selected from the general population and frequency matched according to age, sex and index year using records obtained from the National Health Insurance Research Database between 2000 and 2010. Both cohorts were followed up until the end of 2011 to measure the incidence of stroke. The risk of stroke was analysed using Cox proportional hazard regression models, including factors such as sex, age and comorbidities. RESULTS: We followed the asthmatic patients for 104 697 person-years and followed the nonasthmatic people for 426 729 person-years. The incidence density rate of stroke increased in all of the groups of asthmatic patients compared with that of the controls when stratified according to sex, age and comorbidities. The hazard ratio (HR) of stroke was 1·37-fold greater for the asthmatic cohort, compared with that for the nonasthmatic cohort, after adjusting for sex, age and comorbidities. The adjusted HR of developing stroke substantially increased with older age and the increased frequency of asthmatic exacerbation and hospitalization. The patients receiving beta-2 agonists as a treatment exhibited a significantly greater risk of stroke compared with the patients receiving only inhaled corticosteroids, after adjusting for covariates. CONCLUSION: Asthma may be an independent risk factor for stroke, and its severity exhibits a dose response of stroke development. SN - 1365-2362 UR - https://www.unboundmedicine.com/medline/citation/25207756/Increased_stroke_risk_among_adult_asthmatic_patients_ L2 - https://doi.org/10.1111/eci.12336 DB - PRIME DP - Unbound Medicine ER -