The research has been published today (Thursday 13 August) in Thorax.

Most people will experience a chronic disease, such as asthma, in their lifetime. In the UK approximately a quarter of people aged over 18 years are currently being treated for multiple chronic diseases. Chronic stress has been identified as a risk factor in the development or worsening of many of these conditions. “Allostatic load” is the concept used to measure early ageing or "wear and tear" on the body which accumulates when an individual is exposed to chronic stress in everyday life.

To conduct their study, the researchers compared allostatic load in adults with and without asthma; 9219 adults without asthma, 198 adults with mild asthma which did not require anti-inflammatory treatment with inhaled corticosteroids and 388 adults also with moderate disease treated with inhaled corticosteroids in the UK. To do this, the research team used data which measured levels of stress-related biomarkers in the blood of each participant.

The team found higher allostatic load - early ageing - among even the mildest asthma group (those with doctor diagnosed asthma but not requiring corticosteroids). They found a person with mild asthma had an allostatic load equivalent to a person without asthma who is eight years older.

They also found those with moderate asthma (requiring treatment with corticosteroids) had a higher allostatic load than those without asthma, though this may be confounded by their corticosteroid use which can also affect measurements of allostatic load. This explains the importance of examining individuals with asthma who were not in receipt of a prescription for these medications.

Luke Barry, Research Fellow from the Centre for Public Health at Queen’s University Belfast and first author on the research, said: “This study provides objective measures of a relationship between stress and asthma. Understanding this stress-disease link is important for the management of asthma and in potentially reducing its lifetime burden.

“Our aim with this research is to encourage clinicians to consider stress resilience as part of an individual’s healthcare plan or treatment.”

The researchers suggest active management of stress or policies which aim to remove or reduce social disparities, such as income inequality, which contribute to chronic stress, may delay how early an individual experiences chronic disease in their lifetime or the rate at which their condition worsens.

Professor Liam Heaney, Professor of Respiratory Medicine at the Wellcome-Wolfson Institute for Experimental Medicine at Queen’s University Belfast and corresponding author on the research, said: “Modern lifestyles and social inequalities are important drivers of stress-related disease, which, as our research above demonstrates, includes asthma.

“Stress resilience may be something that could help patients in their daily lives to reduce the effects of chronic disease, and potential worsening of pre-existent chronic conditions. Practices, such as mindfulness-based CBT have been shown to promote stress-resilience and may be an important way to protect against the impacts of chronic disease.”

The next step for the research is to develop a more robust causal understanding of the relationship between stress and asthma through, for example, the use of genetic markers in a person with asthma.

The research was made possible using data from Understanding Society. Understanding Society is an initiative funded by the Economic and Social Research Council and various Government Departments, with scientific leadership by the Institute for Social and Economic Research, University of Essex, and survey delivery by NatCen Social Research and Kantar Public. The research data are distributed by the UK Data Service.

Media

Media inquiries to comms.officer@qub.ac.uk