Prevalence of Arterial Hypertension and Characteristics of Nocturnal Blood Pressure Profile of Asthma Patients According to Therapy and Severity of the Disease: The BADA Study

Int J Environ Res Public Health. 2020 Sep 22;17(18):6925. doi: 10.3390/ijerph17186925.

Abstract

Background: several studies report an increased risk for asthmatic subjects to develop arterial hypertension and the relationship between these two diseases, frequently co-existing, still has some unclear aspects.

Methods: The BADA (blood pressure levels, clinical features and markers of subclinical cardiovascular damage of asthma patients) study is aimed to evaluate the prevalence of the cardiovascular comorbidities of asthma and their impact on the clinical outcome. The main exclusion criteria were the presence of other respiratory diseases, current smoking, any contraindication to ambulatory blood pressure monitoring (ABPM).

Results: The overall percentage of asthmatics having also hypertension was 75% (30 patients) vs. 45% (18 patients) of the control group (p: 0.012). Reduced level of FEV1 (but not inhaled steroid therapy) was associated to newly-diagnosed hypertension (p: 0.0002), higher day SBP levels (p: 0.003), higher day DBP levels (p: 0.03), higher 24 h-SBP levels (p: 0.005) and higher 24h-DBP levels (p: 0.03). The regression analysis performed taking into account sex, age, diabetes, fasting glucose, and body mass index confirms the independent role played by asthma: odds ratio (OR): 3.66 (CI: 1.29-11.1).

Conclusions: hypertension is highly prevalent in asthma; the use of ABPM has allowed the detection of a considerable number of unrecognized hypertensives.

Keywords: asthma; cardiovascular risk; essential hypertension; inhaled corticosteroid therapy; nocturnal dipping of blood pressure.

MeSH terms

  • Adult
  • Aged
  • Asthma* / complications
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Circadian Rhythm*
  • Female
  • Humans
  • Hypertension* / complications
  • Male
  • Middle Aged
  • Patients
  • Prevalence
  • Risk Factors
  • Severity of Illness Index