ASTHMA AND ITS ASSOCIATION WITH CARDIOVASCULAR-DISEASE IN THE ELDERLY

Cardiovascular disease (CVD) is more prevalent in elderly than in midd le-aged patients. Symptoms such as intermittent wheezing with dyspnea may then be due to either CVD or asthma. The objective of this study w as to determine the prevalence and correlates of asthma in the elderly and their associations with CVD and CVD risk factors. A community sam ple of 5201 elderly persons from the Cardiovascular Health Study was a sked if they had a physician diagnosis of asthma, and multiple cardiov ascular risk and disease variables were measured. Six percent of the p articipants (309) recalled a history of asthma, and half of these were never smokers. Thirty percent of those with asthma were currently tak ing a bronchodilator, 14% inhaled steroids, and 10% oral prednisone. M en and women with asthma who were cigarette smokers were more likely t o report a concurrent diagnosis of congestive heart failure than smoke rs without asthma (p = .04). However, when we determined the independe nt CVD correlates of asthma in this cohort, controlling for smoking st atus, age, gender, and diagnoses of chronic bronchitis and emphysema, only higher levels of high-density lipoprotein cholesterol (HDL-C) and higher plasma fibrinogen levels were significantly associated with as thma. It was concluded that asthma is as prevalent in the elderly as i n middle-aged persons and is associated with higher HDL-C and higher f ibrinogen levels, but not with prevalent cardiovascular disease.