Date of Award

8-1-2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Field of Study

Epidemiology

Department

School of Public Health

First Advisor

Martha Felini

Second Advisor

Mohammed El-Faramawi

Third Advisor

Subhash Aryal

Abstract

Asthma has allergic and non-allergic forms. Asthma has been associated with all-cause mortality and CVD-specific mortality, but the role of allergic asthma on these outcomes is unknown. Additionally, allergic rhinitis and its concomitant role with allergic asthma have not been explored for these two specific outcomes. The present study utilized NHANES III and NHANES III-linked mortality files to study the risk of all-cause and CVD-specific mortality due to allergic rhinitis and allergic asthma, independently and concurrently. Unlike previously conducted studies, this is the first cohort study that uniquely focused on allergic forms of rhinitis and asthma using a representative sample of the general US population. Men and women of all racial/ethnic backgrounds (≥40 years) whose mortality was ascertained via National Death Index were included in this study. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated for those with self-reported allergic conditions only, as well as for those that self-reported the allergic conditions and underwent skin testing, for all-cause and CVD-specific mortality. The combined effect for all-cause mortality {HR: 1.23 (95%CI: 0.91, 1.29)} and CVD-specific mortality {HR: 1.66 (95%CI: 0.85, 3.25)} was observed among those that self-reported allergic rhinitis and allergic asthma concurrently. However, results were null among skin test completers only. Based on our findings health practitioners should assess both the conditions simultaneously for better management of these symptoms to reduce the burden of all-cause and CVD-specific mortality.

Comments

Gandhi, Subi. All-cause and CVD-specific mortality associated with allergic rhinitis and allergic asthma: a retrospective cohort study. Doctor of Philosophy (Epidemiology), May 2014. 135 pp., 6 tables, 1 illustration, references, 170 titles.

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