Methods: We assembled a cohort of allergic rhinitis patients (N=109,229) and a cohort of asthma patients (N=92,775) matched 1:1 by age, sex, and ethnicity to reference cohorts and compared the incidence of cardiovascular and cerebrovascular events and all-cause mortality from 1/1/1995 to 12/31/2012 using the Kaiser Permanente Southern California regional database and ICD-9 codes. Hazard ratios (HR) were calculated using survival analysis with a fully adjusted COX proportional model.
Results: Patients with allergic rhinitis had significantly lower risk for acute myocardial infarction (MI) (HR 0.75, 95% CI [0.71, 0.80]) and cerebrovascular disease (HR 0.81, 95% CI [0.77, 0.84]), and all-cause mortality (HR 0.51, 95% CI [0.49, 0.53]). However, their risk of all cardiovascular events was equivalent to the control cohort (HR 0.97, 95% CI [0.94, 1.00]). Patients with asthma had significantly higher risk of all cardiovascular disease (HR 1.36, 95% CI [1.32, 1.40]), however had no significantly increased risk of cerebrovascular disease (HR 1.03, 95% CI [0.99, 1.08]) or all-cause mortality (HR 1.00, 95% CI [0.97, 1.03]).
Conclusions: Our study supported other results that patients with asthma have increased cardiovascular events. However patients with allergic rhinitis have decreased acute MI, cerebrovascular disease, and all-cause mortality. This suggests atopy may not be contributing to the increased cardiovascular events seen in patients with asthma.