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By Lisa Rapaport (Reuters Health) - Childhood asthma rates appear to have stopped rising among many U.S. groups, but not among the poorest kids or children aged 10 and older, a study suggests.

Overall, asthma prevalence among kids under 18 had been rising for decades, until it peaked at 9.7% in 2009. Then it held steady until 2013, when it dropped to 8.3% from 9.3% the previous year, researchers reported online December 28 in the journal Pediatrics.
"International data on asthma prevalence over time shows that trends appear to be leveling off in many countries, and suggests that the trend in the United States seems to be following a general pattern,” said lead study author Dr. Lara Akinbami of the U.S Center for Disease Control and Prevention’s National Center for Health Statistics in Hyattsville, Maryland.

Even though the recent decline is statistically meaningful, it’s too soon to tell whether the decrease from 2012 to 2013 might be the start of another plateau or the beginning of a meaningful decline in asthma cases, Akinbami said by email.

In addition to the scant number of years to assess a shift in asthma trends toward the end of the study period, it’s also possible that changes in the way U.S. researchers collected survey data on childhood asthma might have influenced the results.

“It also doesn’t clearly identify which factors underlie changes in trends,” Akinbami added. “There is likely a complex story on why asthma prevalence has apparently stopped increasing.”

Part of the complexity stems from variations in rates of asthma based on age, income, region or race and ethnicity, the study found. There was no change in asthma prevalence from 2001 to 2013 for white or Puerto Rican children or for kids living in the Northeast or West. Over the same period, prevalence rose for kids aged 10 to 17, poor children, and residents of the South. Disparities in asthma between white and black children stopped increasing, and Puerto Rican kids continued to have the highest prevalence.

For low-income children in particular, it’s possible that environmental risk factors like tobacco exposure, poor housing and poor indoor air quality, and indoor dust mite and cockroach exposure may make asthma more likely, said Dr. Avni Joshi of the Mayo Clinic in Rochester, Minnesota.

“There is a vicious cycle of poverty and obesity which may also contribute to the risk of development and persistence of asthma,” Joshi, who wasn’t involved in the study, said by email. “In addition, children in poor households experience higher psychosocial stress, which is another risk factor for asthma.”

If there’s a silver lining in the study results, it’s that a plateau or decrease in asthma suggests that newer medicines and more aggressive management of the disease may be making a difference, noted Dr. Todd Mahr of Gundersen Health System in La Crosse, Wisconsin.

“It appears that progress is occurring in decreasing the asthma epidemic,” Mahr, who wasn’t involved in the study, said by email.

This article can be found at: http://www.huffingtonpost.com/entry/childhood-asthma-rates-are-leveling-...
NPR segment on the same topic can be found at: http://www.npr.org/sections/health-shots/2015/12/28/460845335/childhood-...

By Randy Dotinga

HealthDay Reporter

TUESDAY, Dec. 8, 2015 (HealthDay News) -- A new study suggests that kids with asthma or allergies like hay fever may face as much as a doubling of their risk of high blood pressure and high cholesterol -- even if they aren't overweight.

However, the risk to any one child remains low, experts stressed, and it's not clear whether allergic diseases directly cause these problems. It's possible that another factor -- such as a lack of exercise -- could play a role.

Still, study author Dr. Jonathan Silverberg, said, "You have common health problems that turn out to have a lot more serious consequences in some kids."

According to Silverberg, an associate professor of dermatology at Northwestern University's Feinberg School of Medicine in Chicago, prior research has shown that adults with allergic disorders are more likely to have risk factors for heart disease. His own research has hinted at links between the skin condition known as eczema, unhealthy life choices such as less physical activity and smoking, and heart disease risk factors. The new study aims to understand whether similar connections might exist in children.

To find out, Silverberg's team examined the results of a 2012 U.S. survey of households and focused on findings regarding more than 13,000 children up to the age of 17. The survey found that about 14 percent of kids in that age range had asthma, 12 percent hadeczema and 16 percent had hay fever.

The new study finds that kids with asthma and hay fever were more likely than other kids to be obese or overweight, and they also had about double the risk of high blood pressure and high cholesterol.

Extra risk remained even after the researchers adjusted their statistics to account for obesity as a factor, Silverberg's group said. The kids did not have a higher risk of diabetes, however.

And the actual increase in risk for high blood pressure and high cholesterol wasn't large. For the kids with asthma and hay fever, the overall level of risk only grew only by about 1 percentage point, the researchers noted.

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