Allergies, Asthma, and CVD: A Deep Breath

Asthma and CVD (cardiovascular disease) often go hand in hand. This is because compromised heart function often leads to lung problems. Now, what happens when we add seasonal allergies on top of that? Given the coming of spring and the beginning of delightful splashes of color and rich greenery washing over the slumbering land… though for many, that beauty comes dusted in pollen, making this season complicated if one has allergies. But is there a connection between CVD and allergies? What about asthma? If you have CVD, asthma, and additional allergies on top of it, is there anything that can be done to help prevent such sneezy seasonal discomfort this year?

Let’s find out.

The article, Association Between Asthma And Cardiovascular Disease by Wee et al. from 2021 highlights this connection. The study was conducted because previous “epidemiological studies on the association between asthma and cardiovascular disease have reported conflicting results. This cross-sectional study evaluated the association between asthma and ischaemic heart disease (IHD)/stroke in Korean adults” (Wee et al., 2021). The results of this study found that, “participants with asthma reported a significantly higher prevalence of IHD (6.0% vs 3.0%) and stroke (2.3% vs 1.4%) than those without asthma (P < .001). Asthmatic participants had a higher OR (1.46, 95% confidence interval [CI] = 1.251-1.71, P < .001) for IHD than those without asthma” (Wee et al., 2021). Furthermore, it concluded that, “asthma was associated with IHD, mainly in older patients and untreated asthma patients, but not with stroke” (Wee et al., 2021). So, in theory, it does not affect everyone equally.

However, another article, Asthma As Risk For Incident Cardiovascular Disease And Its Subtypes by Takumi Hirata comes at it from the perspective of asthma leading to CVD and delves into this connection from the opposite direction from the previous article.

It describes how “there are three possible mechanisms by which asthma is associated with the development of CVD. First, chronic airway inflammation due to asthma contributes to systemic inflammation, and chronic systemic inflammation is expected to lead to the increased vulnerability of blood vessels, activation of coagulability, and dysfunction of vascular endothelial cells, contributing to the progression of atherosclerosis. Second, chronic airway obstruction due to prolonged asthma leads to decreased pulmonary function and hypoxemia, and hypoxia may play an important role in the progression of atherosclerosis by promoting lipid accumulation in macrophages, increased secretion of inflammatory mediators, inducing ATP depletion and angiogenesis. Third, medications for asthma may contribute to the incidence of CVD. For example, a previous cohort study in the United Kingdom reported long-term steroid treatment was associated with an increased risk of CVD in patients with immune-mediated inflammatory diseases. Similarly, although it is [a] controversial issue, the use of inhaled long-acting β2-agonists (LABAs) or long-acting antimuscarinic antagonists (LAMAs) for COPD patients might be associated with an increased risk of CVD. The detailed mechanism by which asthma causes CVD remains unclear, and further basic research will be required to elucidate the mechanism” (Hirata, 2023). With this in mind, not all asthma is created equal, just like how not everyone with compromised cardiovascular health is impacted equally.

As such, the article concludes that “many observational studies have reported that asthma, regardless of the presence of hypertension, increased the risk of incidence and subsequent death from CVD. However, it is difficult to reach definitive conclusions about whether asthma should be treated to prevent the incidence of CVD because it is not practical to design interventional studies to examine whether treatment for asthma reduces the incidence and subsequent death from CVD. Nevertheless, these studies suggested that it is important to provide appropriate management of asthma for patients with asthma who have risk factors for CVD, as well as more intensive management of risk factors for CVD, including smoking, hypertension, diabetes, and dyslipidemia” (Hirata, 2023). The connection between asthma and CVD is clear, but the degree to which each individual is affected is unclear, especially given the underlying behaviors each person engages in that can either help or aggravate the condition.

While seasonal allergies and allergic asthma are distinct conditions, they share a common inflammatory mechanism, meaning the two are closely linked for many sufferers. Therefore, asthma and allergies are still connected; the question is what causes that asthmatic response and how severe it could be. With this in mind, I would encourage the person with asthma and/or CVD to discuss this with their doctor to find out what factors put them at risk and if/how it could be managed.

However, now that we see that the connection between asthma and CVD is not so cut and dry, what is the connection with allergies?

The older article from 2011, Is There An Association Of Allergy And Cardiovascular Disease? by Bergmann and Sypniewska tackles this question directly and concluded ambiguously, saying, “the hypothesis of the relationship between allergies and CVD risk is a matter of controversy. It is possible that chronic allergic diseases, and thus long-lasting inflammation, reflected by increased levels of proinflammatory cytokines may contribute to pathological changes in the circulatory system. This problem requires further population studies. Hopefully, in the future, they will provide valuable insights into the pathogenesis of atherosclerosis and the prevention of cardiovascular disease” (Bergmann and Sypniewska, 2011). However, other articles have also discussed this connection since.

The article, Allergic Asthma Is A Risk Factor For Human Cardiovascular Diseases by Guo et al. in 2022 delves into a more interconnected interpretation of CVD, allergies, and asthma. It states that, “asthma is an allergic airway disease in which type 2-mediated inflammation has a pathogenic role. Cardiovascular diseases (CVDs) are type 1-dominant inflammatory diseases in which type 2 cytokines often have a protective role. However, clinical studies demonstrate that allergic asthma and associated allergies are essential risk factors for CVD, including coronary heart diseases, aortic diseases, peripheral arterial diseases, pulmonary embolism, right ventricular dysfunction, atrial fibrillation, cardiac hypertrophy and even hypertension. Mast cells, eosinophils, inflammatory cytokines and immunoglobulin (Ig)E accumulate in asthmatic lungs and in the injured heart and vasculature of patients with CVD” (Guo et al., 2022). It addresses how, “clinical studies show that many anti-asthmatic therapies affect the risk of CVD. As such, allergic asthma and CVD may share common pathogenic mechanisms. Preclinical investigations indicate that anti-asthmatic drugs have therapeutic potential in certain CVDs. In this Review, we discuss how asthma and allied allergic conditions may contribute to the prevalence, incidence and progression of CVD and vice versa” (Guo et al., 2022). This shows a distinct interdependence between all three factors. However, it concludes that “clinical and preclinical studies have established numerous links between allergic asthma and CVD. The lungs, heart, and vasculature share many cell types, although their functions may differ depending on their environment” (Guo et al., 2022). It continues, noting how “these counterintuitive observations may not challenge the interaction between asthma and CVD but merely reflect our currently incomplete knowledge. Current clinical and laboratory studies affirm the causal contributions of IgE and MCs in asthma, and evidence is accumulating supporting their mechanistic links with CVD. Anti-IgE antibodies and MC inhibitors have shown efficacy in asthma and CVD in humans and animal experiments. EOS, MCs, lymphocytes, mononuclear phagocytes and many other immune cells may have similar roles in the lungs, heart and vasculatures, a hypothesis that provides a fertile field for future research” (Guo et al., 2022). With this in mind, the connection between these factors has been scientifically recognized, but it still seems to require further research to determine the exact extent, nature, and depth of the interlinking among asthma, allergies, and CVD.

Personally, I have CVD and asthma that is managed with an inhaler, and luckily, I have no seasonal allergies, but I am sensitive to mold and other environmental factors. However, while I don’t have experience with allergies myself, I believe that is the point. Everyone’s experience with these three chronic illnesses is unique. Yes, there are trends connecting them in a complicated web, but they are still largely linked to your own medical experience, and how you and your medical provider seek to handle it is something that must be addressed if you have CVD, asthma, and allergies, be they seasonal or otherwise.

My advice is to keep your doctor informed if you develop symptoms of any of these three conditions, and to ensure you receive and maintain appropriate treatment while keeping your doctor informed of any new developments. You might not be able to run from the outdoors, but you can meet it where it stands and become a conqueror of your circumstances rather than a victim of them.

While patterns exist to connect them, it all comes down to the individual’s personal health and how well it is managed. This is the deciding factor in how much of an impact the CVD, asthma, and allergies have on their daily life. So, before you go for a walk in the blossoming forests or through a freshly mowed lawn, be certain to have your asthma medicine and your allergy medicine with you if you have CVD. There is a connection, but I believe how your body fares in these circumstances depends on how well these conditions are managed, not so much on avoiding the triggers themselves.

Would you agree?

Comment below.

Tune in next Monday and Friday for more! I will be writing more now that I’m finally feeling better, so I’m getting a new, more frequent schedule.

Keep ticking, everybody!

P.S. Are there any aspects of CVD health or pacemakers you’d like to know more about?

Feel free to email me at:

blairmueller28@gmail.com

Reference List

Bergmann, K. and Sypniewska, G. (2011). Is There An Association Of Allergy And Cardiovascular Disease? Biochemia Medica, [online] 21(3), pp.210–218. Available at: https://hrcak.srce.hr/clanak/108603 [Accessed 22 Mar. 2026].

Guo, J., Zhang, Y., Liu, T., Levy, B.D., Libby, P. and Shi, G.-P. (2022). Allergic Asthma Is A Risk Factor For Human Cardiovascular Diseases. Nature Cardiovascular Research, [online] 1(5), pp.417–430. doi:https://doi.org/10.1038/s44161-022-00067-z.

Hirata, T. (2023). Asthma As Risk For Incident Cardiovascular Disease And Its Subtypes. Hypertension Research, [online] 46(8), pp.2056–2058. doi:https://doi.org/10.1038/s41440-023-01328-5.

Wee, J.H., Park, M.W., Min, C., Byun, S.H., Park, B. and Choi, H.G. (2021). Association Between Asthma And Cardiovascular Disease. European Journal of Clinical Investigation, [online] 51(3), p.e13396. doi:https://doi.org/10.1111/eci.13396.

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