Who Gets Asthma?
Anyone can get asthma at any age. Among those at higher risk for asthma are people who:
- Have a family history of asthma
- Have a history of allergies (allergic asthma)
- Have smokers living in the household
- Live in urban areas
How is Asthma Classified?
Asthma is classified into four categories based upon frequency of symptoms and objective measures, such as peak flow measurements and/or spirometry results. These categories are: mild intermittent; mild persistent; moderate persistent; and severe persistent. Your physician will determine the severity and control of your asthma based on how frequently you have symptoms and on lung function tests. It is important to note that a person's asthma symptoms can change from one category to another.
Mild intermittent Asthma
- Symptoms occur less than three times a week, and nighttime symptoms occur less than two times per month
- Lung function tests are greater than 80% of predicted values. Predictions are often made on the basis of age, sex, and height
- No medications are needed for long-term control
Mild Persistent Asthma
- Symptoms occur three to six times per week.
- Lung function tests are greater than 80% of predicted values
- Nighttime symptoms three to four times a month
Moderate Persistent Asthma
- Symptoms occur daily
- Nocturnal symptoms greater than five times per month
- Asthma symptoms affect activity, occur more than two times per week, and may last for days
- There is a reduction in lung function, with a lung function test range of 60% to 80% of predicted values
Severe Persistent Asthma
- Symptoms occur continuously, with frequent nighttime asthma.
- Activities are limited.
- Lung function is decreased to less than 60% of predicted values.
How is Asthma Treated?
Asthma can be controlled, but there's no asthma cure. There are, however, certain goals in asthma treatment. If you are unable to achieve all of these goals, it means asthma is not in good control. You should contact your asthma care provider for help with asthma.
The treatment goals include the following:
- Live an active, normal life
- Prevent chronic and troublesome symptoms
- Attend work or school every day
- Perform daily activities without difficulty
- Stop urgent visits to the doctor, emergency room, or hospital
- Use and adjust medications to control asthma with little or no side effects
Properly using asthma medication, as prescribed by your doctor, is the basis of good asthma control, in addition to avoiding triggers and monitoring daily asthma symptoms. There are two main types of asthma medications:
- Anti-inflammatories: This is the most important type of medication for most people with asthma. Anti-inflammatory medications, such as inhaled steroids, reduce swelling and mucus production in the airways. As a result, airways are less sensitive and less likely to react to triggers. These medications need to be taken daily, and may need to be taken for several weeks before they begin to control asthma. Anti-inflammatories lead to a reduction in symptoms, better airflow, less sensitive airways, less airway damage, and fewer asthma episodes. If taken every day, they are helpful in controlling or preventing asthma. Oral steroids are taken for acute flares and help increase the efficacy of other medications and help reduce inflammation.
- Bronchodilators: These medications relax the muscle bands that tighten around the airways. This action rapidly opens the airways, letting more air in and out of the lungs and improving breathing. As the airways open, the mucus moves more freely and can be coughed out more easily. In short-acting forms, bronchodilators known as beta-agonists relieve or stop asthma symptoms and are very helpful during an asthma episode. In long-acting forms, a beta-agonist may be helpful in preventing exercise-induced asthma.
Asthma medications can be taken by inhaling the medications (using a metered dose inhaler, dry powder inhaler, or asthma nebulizer) or by swallowing oral medications (pills or liquids). If you are also taking drugs for other conditions, you should work with your providers to check drug interactions and simplify medications when possible.