Prospective Study of Physical Activity and Risk of Asthma Exacerbations in Older Women

Abstract

Rationale: The potential role of physical activity in preventing asthma exacerbations is unknown. Objectives: To investigate the longitudinal association between regular physical activity and asthma exacerbations. Methods: A total of 2,818 women with asthma from a large U.S. cohort (the Nurses' Health Study) were monitored from 1998 to 2000. Physical activity was self-reported at baseline, using a validated questionnaire, and categorized in quintiles. Exacerbations during follow-up were defined as a self-report of asthma-related hospitalization, emergency department visit, or urgent office visit. Baseline information about severity of asthma, treatment, previous exacerbations, sociodemographic factors, smoking, and other potential confounders was obtained. Measurements and Main Results: Participants had a mean age of 63 years, and 71% had mild-to-moderate persistent asthma. About half of the women were ever-smokers (48% former, 6% current), and median physical activity was 10 METÁhours/week (equivalent to walking at a brisk pace for 20 minutes three times per week). Risk of exacerbations during follow-up decreased with increasing level of physical activity. In a multivariate logistic regression model, the higher level of physical activity, the lower risk of admission (odds ratio 0.85, 0.81, 0.78, and 0.76, for the 2nd, 3rd, 4th, and 5th quintiles compared with the 1st quintile, P for trend 5 0.05). There were no relevant differences on stratifying by age group, smoking status, body mass index, baseline use of inhaled corticosteroids, or previous exacerbations. Conclusions: Regular physical activity was associated with reduced risk of exacerbations in women with asthma in this longitudinal study.

Aerobic training reverses airway inflammation and remodelling in an asthma murine model

“…Interestingly, a recent study showed that asthmatic females with higher physical fitness present with less episodes of asthma exacerbations. The authors hypothesised that an increase in physical fitness should be used as adjuvant treatment in asthma [40], which is supported by our findings.…”

Occupational exposures and uncontrolled adult-onset asthma in the European Community Respiratory Health Survey II

“…Oral corticosteroid used continuously may also be considered as a marker of asthma severity. In previous studies, exacerbations were defined only by hospitalisation or emergency aspects [31], or in addition to the ''use of oral corticosteroids when needed'' to evaluate severe exacerbations [21]. In ECRHS both aspects of exacerbations seem to be linked to occupational exposure to asthmagens [21].…”

Effects of Exercise on the Airways

“…These epidemiological data suggest that increased prevalence of asthma could be a consequence of changes in lifestyle related to physical activity and dietary habits, as confirmed by the increased prevalence of obesity worldwide, also at young age. In addition, a large longitudinal study recently found a decreased risk of asthma exacerbations associated with regular physical activity in older women (Garcia-Aymerich et al, 2009), suggesting that exercise may positively affect asthma control.…”