MedicalResearch.com Interview with:
Aivaras Cepelis, MSci
Department of Public Health and Nursing, Faculty of Medicine and Health Science
NTNU, Norwegian University of Science and Technology
MedicalResearch.com: What is the background for this study?
Response: Atrial fibrillation is the most common sustained, irregular and often rapid heart rate with a lifetime risk of 26%. The number of adults with atrial fibrillation is projected to double by 2050. Atrial fibrillation is also linked to adverse cardiovascular outcomes such as doubled risk of stroke and cardiovascular mortality. Therefore, we believe that research into the novel risk factors of the disease is highly warranted.
One of the potential condition that could play a role in the growing prevalence of atrial fibrillation is asthma. Asthma is a chronic inflammatory airway disease, affecting as many as 30 million children and adults in Europe. High levels of systemic inflammation biomarkers have been reported in both uncontrolled asthmatics and patients with atrial fibrillation. Furthermore, beta-agonists, the most common prescribed asthma control medication, has been shown to influence heart rate and increase the risk of irregular heartbeat.
However, research looking at asthma and atrial fibrillation link are lacking and no previous studies have assessed the dose-response relationship between levels of asthma control and atrial fibrillation. We utilized over 54 000 adults from a large well-defined Norwegian population cohort The Nord-Trøndelag Health Study (HUNT) to explore this association.
MedicalResearch.com: What are the main findings?
Response: We found a 38% increased risk of atrial fibrillation in individuals with physician-diagnosed asthma, and even higher 76% increased risk in those with active asthma characterized by current asthma medication use. In addition, there was a positive dose-response relationship between levels of asthma control and atrial fibrillation risk with the highest risk in those with uncontrolled asthma and no evident risk in those with controlled asthma, compared to individuals without asthma. The association was not explained by higher C-reactive protein levels or beta-agonists use.
MedicalResearch.com: What should readers take away from your report?
Response: Our research is suggestive of the higher risk of developing irregular and often rapid heartbeat in adults with asthma. This risk is particularly enhanced if individual has poor control of their asthma symptoms such as experiencing difficulty breathing and wheezing during the day, which affects their daytime activities, the sleep quality and requires more frequent asthma medication use. Given the high prevalence of asthma, clinicians and adults with asthma should be aware of this connection. However, this is one of the first study examining asthma and atrial fibrillation risk while reasons behind this association are not fully understood.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our study is novel and shows strong association between asthma and atrial fibrillation. As a result, future researchers should investigate the underlying mechanisms of this association, including the role of asthma medication use and inflammation as well as to clarify the causal pathways between asthma, asthma control and atrial fibrillation.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our study relied on the Nord-Trøndelag Health Study, a collaborative effort between the Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Nord-Trøndelag County Council, Central Norway Health Authority and the Norwegian Institute of Public Health. We would like to thank clinicians and other employees at Nord-Trøndelag Hospital Trust for their support and for contributing to data collection in this research project. Furthermore, I would like to personally thank my supervisor Dr. Linn Beate Strand and research team for their excellent work and National Association for Public Health for financial support during the conduct of the study.
Cepelis A, Brumpton BM, Malmo V, et al. Associations of Asthma and Asthma Control With Atrial Fibrillation RiskResults From the Nord-Trøndelag Health Study (HUNT). JAMA Cardiol. Published online July 11, 2018. doi:10.1001/jamacardio.2018.1901
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