Recent studies suggest that asthma, particularly when characterized by neutrophilic or mixed airway inflammation, is associated with a higher prevalence of hypertension. In the 2024 study by Visca and colleagues, roughly one-third of asthmatic patients had hypertension, and sputum neutrophilia was a strong independent predictor even after adjusting for age, body mass index, and other risk factors. This finding points to a biological connection between chronic lower-airway inflammation and systemic vascular changes, rather than a simple overlap of shared risk factors like obesity or sedentary lifestyle.

Another proposed pathway involves growth factors like VEGF, TGF-β, and IL-17, which are upregulated in chronic airway remodeling. These mediators drive angiogenesis and fibrosis within the lungs but may also influence systemic vessels, promoting vascular remodeling and elevated resistance. Autonomic dysregulation is also considered: chronic airway irritation and neural reflex activation may increase sympathetic outflow, raising vascular tone and blood pressure. In addition, the lung’s role in the renin–angiotensin system provides a potential biochemical link, since airway inflammation can alter ACE/ACE2 balance and favor angiotensin II–driven vasoconstriction.

A New Focus for Treatment

The evidence supports a model in which chronic airway inflammation contributes to systemic vascular dysfunction and hypertension through inflammatory, immune-cell, growth factor, autonomic, and hormonal pathways. While more research is needed to prove causality, these findings suggest that controlling airway inflammation, particularly in neutrophilic asthma, could not only improve respiratory outcomes but also reduce cardiovascular risk.

If you have asthma, talk to your doctor about your risk factors for high blood pressure and ensure your lung inflammation is well-managed. Better asthma control could mean a healthier heart.

3. Camargo LDN, Dos Santos TM, de Andrade FCP, et al. Bronchial Vascular Remodeling Is Attenuated by Anti-IL-17 in Asthmatic Responses Exacerbated by LPS. Front Pharmacol. 2020;11:1269. Published 2020 Sep 4. doi:10.3389/fphar.2020.01269