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09 November 2017 : Clinical Research  

Inhaled Corticosteroids in Asthma: Promoting or Protecting Against Atherosclerosis?

Michał Podgórski1ABCDEFG*, Maciej Kupczyk2ABDE, Piotr Grzelak1ABDE, Małgorzata Bocheńska-Marciniak2ACDF, Michał Polguj3ABEF, Piotr Kuna2ADEG, Ludomir Stefańczyk1ACEG

DOI: 10.12659/MSM.904469

Med Sci Monit 2017; 23:5337-5344

Abstract

BACKGROUND: Bronchial asthma is an inflammatory disease of the respiratory system. However, it may also induce systemic effects. Although reports suggest patients with asthma are at increased risk of cardiovascular events, the association between asthma and atherosclerosis is unclear. The aim of the present study was to compare the progression of atherosclerosis between patients with asthma treated with inhaled corticosteroids and healthy controls.

MATERIAL AND METHODS: In 102 adult patients with asthma, markers of arterial stiffness (pulse wave velocity and augmentation index) were evaluated by applanation tonometry. Structural atherosclerotic changes (intima-media complex thickness and presence of atherosclerotic plaque) were assessed sonographically. Lipid profile and fasting glucose level were measured. Clinical data concerning the course of asthma, its severity, and management strategy were obtained. A group of 102 healthy, age-matched controls were examined according to the same protocol.

RESULTS: The majority of patients presented well-controlled asthma of moderate severity. When adjusted for weight, age, and systolic blood pressure, no significant differences were observed in pulse wave velocity, in augmentation index, or in intima-media complex thickness between groups. In controls, atherosclerotic plaque occurred significantly more often than in patients with asthma (p=0.0226). Moreover, in patients with asthma, the intima-media complex thickness of the right common carotid artery was significantly correlated with forced expiratory volume in 1 second (R²=–0.2951, p=0.0083). There was no significant difference in any of the atherosclerosis markers between different types and doses of administered inhaled corticosteroids.

CONCLUSIONS: Patients with bronchial asthma presented a decreased risk of atherosclerosis in comparison to healthy controls.

Keywords: Anti-Asthmatic Agents, Asthma, atherosclerosis, carotid intima-media thickness, Pulse Wave Analysis

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750