Cheap Asthma Inhalers - Buy Asthma Inhalers online
Buy Asthma Inhalers Online | Cheap Asthma Inhalers Online | Buy Ventolin Inhaler Online | Order Generic Flovent | Buy Proventil Online | Serevent Dosage | Cheap Generic Spiriva Inhaler | Purchase Xopenex Inhaler Online - High Quality Medications. Buy Asthma Inhalers Online Over the Counter



Buy Asthma Inhalers Online

-

Asthma in the Elderly: Prognostic Factors

cardiovascular diseasesPeople with and without asthma were similar with respect to demographic characteristics. Physical performance was, as expected, slightly worse in the group with asthma, and in this group we also found a higher prevalence of depressed mood. No difference was found, instead, with regard to cognitive performance. Eversmokers were more prevalent in the group with asthma (56.2% vs 47.8%). We found only minimal difference between groups in the prevalence of cerebrovascular disease and diabetes, while cardiovascular diseases (including heart failure) were more prevalent in the group with asthma (Table 1).

Mortality in Asthma and Control Populations

We recorded 56 deaths in the asthma group and 180 deaths in the control group, corresponding to a risk of death at 60 months estimated using the product-limit method of 24.3% for asthmatics and 16.3% for control subjects (p < 0.01 for both log-rank and Wilcoxon tests). The corresponding survival curves are presented in Figure 1. The association of asthma with mortality was confirmed in subgroups identified by gender, age ( 75 years), and in people with low BMI, but not in people with severe comorbidity (Charlson index > 1), obesity, or in neversmokers.

Causes of death are reported in Table 2. The control group showed a much lower mortality for nonneoplastic lung disease (ICD9 codes 460-500; 5.4% vs 28.8% in the asthma group, p < 0.001), while mortality for cerebrovascular/cardiovascular diseases (ICD9 codes 400-440) was similar in the two groups. People with asthma had a slightly lower cancer mortality rate (ICD9 codes 140-240; 17.3% vs 29.8% in the control group, p = 0.163). In the multivariable analysis including potential confound-ers and terms for the interaction between diagnosis of asthma and the potential effect modifiers shown above (smoking, comorbidity, and underweight), we found that asthma was not associated with increased mortality in this population (HR, 0.77; 95% confidence interval [CI], 0.36 to 1.62).

Prognostic Factors in the Control Group

At univariable analysis, in the control group we found that demographic, clinical, and functional variables were all associated with death (Table 3). After correction for potential confounders, the association was confirmed for gender (HR for men vs women: 1.89; 95% CI, 1.28 to 2.80), age (HR for 5-year increments, 1.62; 95% CI, 1.44 to 1.83), smoking (HR, 1.52; 95% CI, 1.03 to 2.22), cardiovascular diseases (HR, 1.76; 95% CI, 1.22 to 2.54), performance on 6MWT (HR for 10% increments, 0.95; 95% CI, 0.90 to 1.00), cognitive impairment (HR, 1.93; 95% CI, 1.28 to 2.90), depressed mood (HR, 1.60; 95% CI, 1.14 to 2.25), and FEV1 (HR for 5% increments, 0.95; 95% CI, 0.91 to 0.98).

Prognostic Factors in Asthmatics

Results from univariable analysis are reported in Table 4 (second column). Age, comorbidity, underweight, physical performance, cognitive impairment, and depression were all associated with death, as were cardiovascular diseases and respiratory function.

In the multivariable model also including smoking habit (Table 4, third column), only age (HR for 5-year increments, 1.38; 95% CI, 1.07 to 1.77), smoking (HR for eversmokers vs neversmokers, 2.50; 95% CI, 1.01 to 6.18), and depressed mood (HR, 2.74; 95% CI, 1.30 to 5.76) were associated with increased mortality; while being overweight was associated with lower mortality (HR, 0.35; 95% CI, 0.13 to 0.94). Underweight, which showed the strongest association with death in the crude analysis, was still one of the strongest correlates of death after correction for potential confounders, although with wide CIs (HR, 2.21; 95% CI, 0.94 to 5.18).

This analysis was repeated in people with depression; with the limitation due to loss of power, in this subgroup gender emerged as an important risk factor, with men having a threefold increase in mortality rate compared to women (HR, 3.30; 95% CI, 1.53 to 10.35), and the association between death and being underweight was confirmed (HR, 3.14; 95% CI, 1.00 to 9.86).

Fig1

Figure 1. Kaplan-Meier estimate of survival in the people with (solid line) or without (dashed line) asthma (log-rank test, p < 0.01).

Table 1—Demographic and Clinical Characteristics of Patients

Characteristics Control Group (n = 1,027) Asthma Group (n = 210) Overall
Male gender 47.4 47.6 47.4
Age, yr 73.6 (6.4) 73.2 (6.1) 73.5 (6.2)
College education 5.8 5.3 5.7
Eversmokers 47.8 56.2 49.2
Overweight (BMI > 29 kg/m2) 23.0 31.9 23.9
Underweight (BMI < 22 kg/m2) 13.0 11.0 13.1
Charlson index > 1 18.5 15.7 18.0
Prevalence of cardiovascular disease 14.5 21.4 15.7
Prevalence of cerebrovascular disease 7.0 4.8 6.0
Prevalence of diabetes 12.3 11.0 12.2
Mean 6MWD, % predicted 83.5 (29.2) 76.6 (28.8) 80.8 (29.4)
Cognitive impairment (MMSE < 24) 13.6 12.9 13.8
Depressed mood (GDS > 5) 32.8 40.0 34.6
SGRQ score 3.4 (8.8) 34.2 (20.9) 14.4 (21.9)
FEVj, % predicted 94.1 (18.6) 65.8 (23.2) 82.1 (25.9)
FVC, % predicted 87.3(15.7) 73.3 (18.9) 81.4(18.3)
FEVj/FVC 75.5 (9.0) 62.7 (14.7) 69.3 (14.5)

Table 2—Causes of Death

Causes of Death Control

Subjects (n = 168)

Asthmatics (n = 52)
Nonneoplastic lung disease 5.4 28.8
Cardiovascular disease 39.9 36.5
Malignant tumors 29.8 17.3

Table 3—Crude and Adjusted Analysis of the Risk of Death in Control Patients Associated With Demographic, Clinical, and Respiratory Characteristics

Characteristics Unadjusted HR (95% CI) Adjusted

HR (95% CI)

Male vs female gender 1.52 (1.17-1.99) 1.89(1.28-2.80)
Age in 5-yr increments 1.77(1.62-1.94) 1.62 (1.44-1.83)
Eversmoker vs neversmoker 1.26 (0.97-1.65) 1.52 (1.03-2.22)
Overweight (BMI > 29 kg/m2) 0.70 (0.50-0.98) 1.00(0.67-1.48)
vs normal weight
Underweight (BMI < 22 kg/m2) 2.13 (1.56-2.92) 1.42 (0.94-2.14)
vs normal weight
Charlson index > 1 2.43 (1.84-3.23) 1.43 (0.96-2.12)
Cardiovascular disease 2.34 (1.77-3.18) 1.76(1.22-2.54)
Cerebrovascular disease 2.16 (1.45-3.22) 0.98(0.58-1.67)
Diabetes 1.65 (1.17-2.33) 1.18 (0.75-1.86)
Mean 6MWD in % predicted 0.86 (0.82-0.91) 0.95 (0.90-1.00)
Cognitive impairment (MMSE 2.76 (2.05-3.71) 1.93(1.28-2.90)
< 24)
Depressed mood (GDS > 5) 2.07 (1.58-2.71) 1.60(1.14-2.25)
Mean SGRQ 1.07(1.04-1.09) 1.01 (0.98-1.05)
FEV1 in 5% increments 0.92 (0.89-0.95) 0.95 (0.91-0.98)
FVC in 5% increments 0.92 (0.88-0.96)
FEVj/FVC in 5% increments 0.87 (0.82-0.92)

Table 4—Crude and Adjusted Analysis of the Risk of Death in Asthmatic Patients Associated With Demographic, Clinical, and Respiratory Characteristics

Characteristics Unadjusted

HR (95% CI)

Adjusted

HR (95% CI)

Male vs female gender 1.45 (0.85-2.47) 1.38(1.07-1.77)
Age in 5-yr increments 1.61 (1.32-1.96) 1.75 (0.73-4.19)
Eversmoker vs neversmoker 1.70 (0.96-2.99) 2.50(1.01-6.18)
Overweight (BMI > 29 kg/m2) 0.33 (0.15-0.69) 0.35 (0.13-0.94)
vs normal weight
Underweight (BMI < 22 kg/m2) 4.34 (2.39-7.89) 2.21 (0.94-5.18)
vs normal weight
Charlson index > 1 2.14(1.16-3.93) 1.23 (0.50-3.01)
Cardiovascular disease 2.31 (1.32-4.03) 1.43 (0.66-3.10)
Cerebrovascular disease 2.26 (0.90-5.67)
Diabetes 1.39 (0.68-2.84)
6MWD in increments of 10% 0.84 (0.76-0.93) 0.97 (0.86-1.11)
predicted
Cognitive impairment (MMSE 3.83 (2.12-6.92) 1.70 (0.73-3.96)
< 24)
Depressed mood (GDS > 5) 3.57 (1.97-6.46) 2.74(1.30-5.76)
SGRQ score in 4-point 1.10(1.05-1.16) 1.04(0.98-1.11)
increments
FEV1 in increments of 5% of 0.91 (0.86-0.97) 0.96 (0.89-1.04)
predicted
FVC in 5% increments 0.97 (0.90-1.04)
FEV1/FVC in 5% increments 0.85 (0.77-0.94)
Inhaled p2-adrenergic drugs 1.12 (0.66-1.91)
Inhaled corticosteroids 0.88 (0.50-1.56)
Asthma Inhaler List
News


  Print this Page   


  • Be a fan on Facebook
  • Follow us on Twitter
  • Follow us on Livejournal

NB: Before buying your asthma inhaler online and using it, please make sure you get a consultation from a qualified professional. Your doctor is the only person that can decide, based on your needs and individual factors, which type of medicine you need, giving you a prescription for it.

NB2: All products available on the website are reviewed for information purpose only. This website is in no way affiliated with any companies or endorses the products reviewed.


Copyright © 2011 - 2017 buy-asthma-inhalers-online.com