Total and Cardiovascular Mortality Risk Associated with Allergic Rhinitis and Allergic Asthma: A Retrospective Cohort Study

Title: Total and Cardiovascular Mortality Risk Associated with Allergic Rhinitis and Allergic Asthma: A Retrospective Cohort Study Background: Asthma and allergic rhinitis are two major respiratory conditions of public health concern worldwide. These conditions are also identified as risk factors for atherosclerosis, a contributor of cardiovascular outcomes. Our objectives were to investigate the independent and concomitant role of allergic rhinitis and asthma on cardiovascular and all-cause mortality. Methods and findings: The study participants consisted of a probability sample of US civilians from the Third National Health and Nutrition Examination Survey; vital status was ascertained through the National Death Index. Men and women ≥40 years from all racial/ethnic backgrounds were included in the study. For all-cause mortality (n=9,450) and CVD-specific mortality (n=9,410), the baseline characteristics of participants were similar except for age, education, and smoking status. For both the outcomes, hazard ratios were estimated using Cox regression models. Risk for all-cause mortality increased for those with histories of allergic rhinitis [HR: 1.08 (95%: 0.91-1.29)], and asthma [HR: 1.36 (95%: 1.00-1.89)] whereas risk for CVD-specific mortality showed null association for those with histories of allergic rhinitis [HR: 1.00 (95%: 0.75-1.31)], with elevated risk for those with asthma [HR: 1.32 (95%: 0.85-2.06)]. The combined effect of allergic rhinitis and asthma showed increased risk for all-cause mortality [HR: 1.23 (95%: 0.91-1.29)] and CVD-specific mortality [HR: 1.66 (95%: 0.85-3.25)]. Conclusion: Our study provides preliminary evidence of the independent and concurrent association between allergic rhinitis and asthma and all-cause and CVD-specific mortality.