Journal of CardioVascular Insights

Abstract

Background: Asthma and Pulmonary Arterial Hypertension (PAH) share pathological mechanisms, includ ing chronic inflammation, smooth muscle hyperplasia, and the activation of the nuclear factor of activated T cells (NFAT) pathway. However, the clinical correlation between the two diseases is understudied.

Methods: We conducted a retrospective cross-sectional study utilizing the Nationwide Inpatient Sample data base from 2016 to 2020, which included adults aged ≥18 years. Using ICD-10 codes, PAH and asthma were identified. Secondary pulmonary hypertension (PH) and comorbidities known to be associated with PH were excluded. Logistic regression estimated adjusted odds ratios for PAH, controlling for age, sex, race, chronic kidney disease (CKD), diabetes, hypertension, dyslipidemia, and smoking.

Results: Among 18,767,441 hospitalizations, 1,496 had PAH. Patients with PAH were older (mean age: 60.4 vs 52.4 years) and more often female (73.2% vs 61.6%). Asthma prevalence was higher in PAH (9.1% vs 6.7%). Adjusted analysis revealed that asthma was associated with PAH (aOR 1.47, 95% CI 1.23-1.76, p < 0.001). Other factors significantly associated with PAH included female sex, older age, Black, Hispanic, and Asian/Pacific Islander race, diabetes, and dyslipidemia.

Conclusion: Asthma was associated with 47% higher odds of PAH. Findings support a potential shared NFAT-mediated mechanism. Prospective studies are needed to clarify temporality and assess whether asthma therapies influence PAH risk.