AUTHOR=Visca Dina , Ardesi Francesco , Zappa Martina , Pignatti Patrizia , Grossi Sarah , Vanetti Marco , Migliori Giovanni Battista , Centis Rosella , Angeli Fabio , Spanevello Antonio 

TITLE=Asthma and hypertension: the role of airway inflammation

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1451625

DOI=10.3389/fmed.2024.1451625

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Introduction</title><p>Asthma is a chronic inflammatory respiratory disease often associated with comorbidities. Among cardiovascular comorbidities, arterial hypertension seems to create an additional health burden in asthmatics. However, evidence on this relationship is lacking.</p></sec><sec id="sec2"><title>Objective</title><p>Our study aims to evaluate the characteristics of hypertensive asthmatics, focusing on the role of inflammation as a possible link between these diseases.</p></sec><sec id="sec3"><title>Methods</title><p>We conducted a monocentric retrospective analysis consecutively including asthmatics who underwent induced sputum (IS) at our asthma referral center. Patients were divided in two groups according to presence or absence of history of hypertension. Clinical, functional, and inflammatory (airway and systemic) data were collected.</p></sec><sec id="sec4"><title>Results</title><p>Data on two hundred and sixty asthmatic patients were analyzed. Seventy-nine (30.4%) of them had a diagnosis of hypertension requiring a specific pharmacological treatment. Asthmatics with hypertension were more frequently male (<italic>p</italic> = 0.047), older (<italic>p</italic> &lt; 0.001), and with higher body max index (BMI) (p &lt; 0.001) when compared to normotensive patients. No difference concerning asthma control, severity and pharmacological treatment was observed between the two groups (all <italic>p</italic> &gt; 0.05); distribution of comorbidities and lung function impairment (forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC); all <italic>p</italic> &lt; 0.05) were statistically different between groups. Mixed granulocytic airway inflammation was prevalent in the hypertensive asthmatics (<italic>p</italic> = 0.014). Interestingly, a multivariable analysis revealed that age ≥ 65 years and an increased percentage of sputum neutrophils (≥61%) were independent predictors of hypertensive status (<italic>p</italic> &lt; 0.001).</p></sec><sec id="sec5"><title>Conclusion</title><p>Our data suggest that neutrophilic airway inflammation (as evaluated by induced sputum) is strictly associated with hypertension. In clinical practice, phenotyping asthmatic patients with comorbidities like hypertension could be useful also from a therapeutic point of view. Additional studies are mandatory to further elucidate the role of neutrophilic airway inflammation in asthma with cardiovascular diseases.</p></sec>