Abstract
BACKGROUND: It has been shown that asthma is potentially linked to a higher risk of cardiovascular disease (CVD) and cardiovascular mortality (CVM). OBJECTIVES: This study aims to systematically review and summarize epidemiological evidence on the relationship between asthma and these cardiovascular outcomes. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND METHODS: This meta-analysis, registered with PROSPERO (CRD 42024576126), utilized data from PubMed, Embase, the Cochrane Library, and references from included studies. The search covered literature from the inception of these databases until July 17, 2024. We included observational studies examining the link between asthma and CVD and CVM. Bias risk was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). We calculated pooled relative risk (RR) with a 95% confidence interval (CI) using a random-effects model. RESULTS: A total of 29 studies encompassing 11,380,027 participants were included. The overall risk for CVD in asthma patients was 1.30 (95% CI: 1.20-1.42). Specific CVD risks were elevated for coronary heart disease (CHD, RR 1.35; 95% CI: 1.27-1.42), angina pectoris (AP, RR 1.48; 95% CI: 1.16-1.89), myocardial infarction (MI, RR 1.33; 95% CI: 1.25-1.41), and heart failure (HF, RR 1.53; 95% CI: 1.04-2.23). Asthma was also associated with a higher risk of CVM (RR 1.26; 95% CI: 1.05-1.51). CONCLUSION: Asthma is associated with a higher risk of developing CVD, including specific types such as CHD, AP, MI, and HF. In addition, asthma patients face an increased risk of cardiovascular mortality compared to non-asthmatics.