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Bronchial thermoplasty improves asthma regardless of socioeconomic status American College of Chest Physicians
EurekAlert (press release) Shanghai (April 11, 2016)–Among people with asthma, lower socioeconomic status, education level, and ethnic minority status clearly have undesirable effects on their care and outcomes. Patients with severe disease who attend county (public) hospitals … |
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Bronchial thermoplasty improves asthma regardless of socioeconomic status
Medical Xpress Among people with asthma, lower socioeconomic status, education level, and ethnic minority status clearly have undesirable effects on their care and outcomes. Patients with severe disease who attend county (public) hospitals in the United States tend … |
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Effect of smoking status on the efficacy of the SMART regimen in high risk asthma.
Respirology. 2016 Feb 21;
Authors: Pilcher J, Patel M, Reddel HK, Pritchard A, Black P, Shaw D, Holt S, Weatherall M, Beasley R
Abstract
BACKGROUND AND OBJECTIVE: The optimal management of people with asthma with a significant smoking history is uncertain. The aim of this study was to determine whether the efficacy/safety profile of single combination inhaled corticosteroid (ICS)/long acting beta-agonist (LABA) inhaler maintenance and reliever therapy is influenced by smoking status.
METHODS: We undertook secondary analyses from an open-label 24-week randomized study of 303 high risk adult asthma patients randomized to budesonide/formoterol 200/6-µg-metred dose inhaler for maintenance (two actuations twice daily) and either budesonide/formoterol 200/6-µg-metred dose inhaler one actuation (‘single ICS/LABA maintenance and reliever therapy (SMART)’ regimen) or salbutamol 100?µg 1-2 actuations for symptom relief (‘Standard’ regimen). Smoking status was classified in to three groups, as ‘current’, ‘ex’ or ‘never’, and a smoking/treatment interaction term tested for each outcome variable. The primary outcome variable was number of participants with at least one severe exacerbation.
RESULTS: There were 59 current, 97 ex and 147 never smokers included in the analyses. The smoking status/treatment interaction term was not statistically significant for any of the outcome measures. With adjustment for smoking status, the number of participants with severe exacerbations was lower with the SMART regimen (OR 0.45, 95% CI: 0.26-0.77, P?=?0.004; P value for interaction between smoking status and treatment 0.29).
CONCLUSION: We conclude that the favourable safety/efficacy profile of the SMART regimen applies to patients with high risk asthma, irrespective of smoking status.
PMID: 26897389 [PubMed – as supplied by publisher]
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4 Lesser-Known Factors Affecting Asthma Status
Pharmacy Times Well-known risk factors for asthma development include a family history of the disease, other allergic conditions, obesity, and smoking. However, pharmacists should also be aware of the following lesser-known factors, which can increase patients … |
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The Hispanic health paradox across generations: the relationship of child generational status and citizenship with health outcomes.
Public Health. 2015 May 19;
Authors: Balcazar AJ, Grineski SE, Collins TW
Abstract
OBJECTIVES: In examining the Hispanic health paradox, researchers rarely determine if the paradox persists across immigrant generations. This study examines immigrant respiratory health disparities among Hispanic children in terms of current asthma, bronchitis, and allergies using an expanded six-group immigrant cohort framework that includes citizenship and the fourth-plus generation.
STUDY DESIGN: Cross-sectional primary survey data from 1568 caretakers of Hispanic schoolchildren in El Paso, Texas (USA), were utilized.
METHODS: Data were analyzed using generalized linear models.
RESULTS: Results indicate that a healthy immigrant advantage lasts until the 2.5 generation for bronchitis and allergies (P < 0.05), and until the third generation for asthma (P < 0.10). Citizenship was not an influence on the likelihood of a child having a respiratory health condition.
CONCLUSIONS: Findings demonstrate the utility of the expanded six-group cohort framework for examining intergenerational patterns in health conditions among immigrant groups.
PMID: 26002345 [PubMed – as supplied by publisher]
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Iron Status is Associated with Asthma and Lung Function in US Women.
PLoS One. 2015;10(2):e0117545
Authors: Brigham EP, McCormack MC, Takemoto CM, Matsui EC
Abstract
BACKGROUND: Asthma and iron deficiency are common conditions. Whether iron status affects the risk of asthma is unclear.
OBJECTIVE: To determine the relationship between iron status and asthma, lung function, and pulmonary inflammation.
METHODS: Relationships between measures of iron status (serum ferritin, serum soluble transferrin receptor (sTfR), and sTfR/log10ferritin (sTfR-F Index)) and asthma, lung function, and pulmonary inflammation were examined in women 20-49 years in the National Health and Nutrition Examination Survey. Logistic, linear, and quadratic regression models accounting for the survey design of NHANES were used to evaluate associations between iron status and asthma-related outcomes and were adjusted for race/ethnicity, age, smoking status, income, and BMI.
RESULTS: Approximately 16% reported a lifetime history of asthma, 9% reported current asthma, and 5% reported a recent asthma episode/attack (n = 2906). Increased ferritin (iron stores) was associated with decreased odds of lifetime asthma, current asthma, and asthma attacks/episodes in the range of ferritin linearly correlated with iron stores (20-300ng/ml). The highest quintile of ferritin (>76 ng/ml) was also associated with a decreased odds of asthma. Ferritin levels were not associated with FEV1. Increased values of the sTfR-F Index and sTfR, indicating lower body iron and higher tissue iron need, respectively, were associated with decreased FEV1, but neither was associated with asthma. None of the iron indices were associated with FeNO.
CONCLUSION: In US women, higher iron stores were inversely associated with asthma and lower body iron and higher tissue iron need were associated with lower lung function. Together, these findings suggest that iron status may play a role in asthma and lung function in US women.
PMID: 25689633 [PubMed – as supplied by publisher]
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Asthma affects behavior of low socioeconomic status children
The Maneater Growing up with asthma may affect children of low socioeconomic status, even when they are able to catch their breath. A doctoral study by Jen-Hao Chen, now an assistant professor of the MU School of Health Professions, shows that children with asthma … |
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Science World Report |
Socioeconomic Status Ultimately Influences The Long-Term Effects of Childhood …
Science World Report "As with all chronic illnesses, there is a biological mechanism behind asthma, but asthmatic children's prognoses depend heavily on parental management, and successful management often relies on social circumstances," said Jen-Hao Chen, an assistant … |
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Medical Xpress |
Long-term effects of childhood asthma influenced by socioeconomic status
Medical Xpress "As with all chronic illnesses, there is a biological mechanism behind asthma, but asthmatic children's prognoses depend heavily on parental management, and successful management often relies on social circumstances," said Jen-Hao Chen, an assistant … |
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Association of vitamin D status with arterial blood pressure and hypertension risk: a mendelian randomisation study.
Lancet Diabetes Endocrinol. 2014 Jun 25;
Authors: Vimaleswaran KS, Cavadino A, Berry DJ, LifeLines Cohort Study investigators, Jorde R, Dieffenbach AK, Lu C, Alves AC, Heerspink HJ, Tikkanen E, Eriksson J, Wong A, Mangino M, Jablonski KA, Nolte IM, Houston DK, Ahluwalia TS, van der Most PJ, Pasko D, Zgaga L, Thiering E, Vitart V, Fraser RM, Huffman JE, de Boer RA, Schöttker B, Saum KU, McCarthy MI, Dupuis J, Herzig KH, Sebert S, Pouta A, Laitinen J, Kleber ME, Navis G, Lorentzon M, Jameson K, Arden N, Cooper JA, Acharya J, Hardy R, Raitakari O, Ripatti S, Billings LK, Lahti J, Osmond C, Penninx BW, Rejnmark L, Lohman KK, Paternoster L, Stolk RP, Hernandez DG, Byberg L, Hagström E, Melhus H, Ingelsson E, Mellström D, Ljunggren O, Tzoulaki I, McLachlan S, Theodoratou E, Tiesler CM, Jula A, Navarro P, Wright AF, Polasek O, International Consortium for Blood Pressure (ICBP), Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, Global Blood Pressure Genetics (Global BPGen) consortium, Caroline Hayward, Wilson JF, Rudan I, Salomaa V, Heinrich J, Campbell H, Price JF, Karlsson M, Lind L, Michaëlsson K, Bandinelli S, Frayling TM, Hartman CA, Sørensen TI, Kritchevsky SB, Langdahl BL, Eriksson JG, Florez JC, Spector TD, Lehtimäki T, Kuh D, Humphries SE, Cooper C, Ohlsson C, März W, de Borst MH, Kumari M, Kivimaki M, Wang TJ, Power C, Brenner H, Grimnes G, van der Harst P, Snieder H, Hingorani AD, Pilz S, Whittaker JC, Järvelin MR, Hyppönen E
Abstract
BACKGROUND: Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with blood pressure and hypertension risk.
METHODS: In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta-analysed data for up to 108?173 individuals from 35 studies in the D-CarDia collaboration to investigate associations between the allele score and blood pressure measurements. We complemented these analyses with previously published summary statistics from the International Consortium on Blood Pressure (ICBP), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and the Global Blood Pressure Genetics (Global BPGen) consortium.
FINDINGS: In phenotypic analyses (up to n=49?363), increased 25(OH)D concentration was associated with decreased systolic blood pressure (? per 10% increase, -0·12 mm Hg, 95% CI -0·20 to -0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97-0·99; p=0·0003), but not with decreased diastolic blood pressure (? per 10% increase, -0·02 mm Hg, -0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D-CarDia and the ICBP (n=146?581, after exclusion of overlapping studies), each 25(OH)D-increasing allele of the synthesis score was associated with a change of -0·10 mm Hg in systolic blood pressure (-0·21 to -0·0001; p=0·0498) and a change of -0·08 mm Hg in diastolic blood pressure (-0·15 to -0·02; p=0·01). When D-CarDia and consortia data for hypertension were meta-analysed together (n=142?255), the synthesis score was associated with a reduced odds of hypertension (OR per allele, 0·98, 0·96-0·99; p=0·001). In instrumental variable analysis, each 10% increase in genetically instrumented 25(OH)D concentration was associated with a change of -0·29 mm Hg in diastolic blood pressure (-0·52 to -0·07; p=0·01), a change of -0·37 mm Hg in systolic blood pressure (-0·73 to 0·003; p=0·052), and an 8·1% decreased odds of hypertension (OR 0·92, 0·87-0·97; p=0·002).
INTERPRETATION: Increased plasma concentrations of 25(OH)D might reduce the risk of hypertension. This finding warrants further investigation in an independent, similarly powered study.
FUNDING: British Heart Foundation, UK Medical Research Council, and Academy of Finland.
PMID: 24974252 [PubMed – as supplied by publisher]
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