Eosinophilia and positive skin tests predict cardiovascular mortality in ageneral population sample followed for 30 years

The authors investigated whether two objective allergy markers, peripheral blood eosinophilia and skin tests for common aeroallergens, were associated with cardiovascular death. Of 5,382 subjects in the Vlagtwedde-Vlaardingen Study (the Netherlands) with data on allergy markers in 1965-1972, 507 sub jects died from cardiovascular disease during 30 years of follow-up, Subjec ts with eosinophilia had an increased risk of cardiovascular death (relativ e risk (RR) = 1.7; 95% confidence interval (CI): 1.4, 2.2), including ische mic heart disease death (RR = 1.6, 95% CI: 1.2, 2.2) and cerebrovascular de ath (RR = 2.3; 95% CI: 1.4, 3.8), independent of major risk factors. This a ssociation was limited to subjects with a percentage of the predicted force d expiratory volume in 1 second (FEV1 % predicted) of <100%, Positive skin tests were associated with a significantly reduced cardiovascular mortality in subjects with normal lung function and weight who did not smoke (RR = 0 .15; 95% CI: 0.05, 0.46). Conversely, when subjects with positive skin test s had a body mass index of greater than or equal to 25 kg/m(2), had an FEV1 % predicted of <80%, or smoked, they had an increased risk for cardiovascu lar mortality. These results were not restricted to asthmatics. Our data su ggest a possible link between eosinophilia and positive skin tests and card iovascular mortality, especially in combination with other risk factors ass ociated with its mortality.