Asthma and allergic rhinitis may increase the risk of angina, coronary heart disease (CHD) and myocardial infarctions (MI), according to an analysis of 603,140 people from the US National Health Interview Survey. 

In the analysis, 11.4 per cent reported at least one of four heart conditions during the 20-year study: heart condition/disease (7.4 per cent); CHD (4.3 per cent); MI (3.2 per cent); and angina (2.2 per cent). Experiencing at least one asthma attack in the last year (odds ratio [OR] 2) or a lifetime diagnosis of asthma (OR 1.7) approximately doubled the risk of developing any of the four CV conditions. Allergic rhinitis in the last year increased the risk of developing any of the four conditions by 32 per cent.

Experiencing at least one asthma attack in the last year approximately doubled the risk of heart condition/disease (odds ratio [OR] 1.9); CHD (OR 1.7); MI (OR 1.8); and angina (OR 2.4).

A lifetime diagnosis of asthma also increased the risk of heart condition/disease (by 64 per cent), CHD (by 36 per cent), MI (by 43 per cent) and angina (by 79 per cent). 

Allergic rhinitis in the last year increased the risk of heart condition/disease (by 33 per cent), CHD (by 25 per cent), MI (by 20 per cent) and angina (by 58 per cent).

While inflammation and dysregulated immune reactions may link the conditions, an improved understanding of the underlying mechanisms could inform management. In the meantime, the authors suggest screening people with severe and/or uncontrolled asthma and allergic rhinitis for CVD, especially angina and CHD. 

They add that “primary care providers should ask patients about lifetime asthma and allergic rhinitis, even if patients are self-managing allergies with over-the-counter medications”.