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General Information About Asthma

Asthma Week

Asthma is a chronic, inflammatory disease of the lungs that impacts children and adults across the lifespan and throughout the world. Recent data from the Centers for Disease Control indicate that, in the United States, 7.1 million children and 18.9 million adults currently have asthma, making it one of the most prevalent chronic diseases. Asthma is twice as common in African American children as compared to Caucasians. Given this, about 8.5% of people have asthma, significantly impacting the lives of patients and costing the US approximately $56 billion each year in medical costs, lost school and work days and early deaths. Asthma was responsible for 1.8 million emergency department visits in 2010. In addition, despite significant advances in the clinical care of patients with asthma, their numbers continue to increase. Maternal smoking and intrauterine exposure to phthalates (found in some plastics) are known risk factors for childhood asthma.

The inflammation that underlies asthma most prominently impacts the airways of the lungs. Over time, this inflammation leads to changes that result in narrowing and obstruction of these airways (‘remodeling), blocking the flow of air and making it more difficult for patients to breathe. This obstruction is associated with exaggerated constriction in response to cold air, exercise or chemical triggers (a phenomenon known as “hyperresponsiveness”) and tends to improve with administration of medications that relax and open the airways (inhaled bronchodilators). Another prominent feature of the inflammation seen in asthma is that it is frequently intermittent, brought on by triggers such as viral illnesses, exposure to airborn allergens including dust, mold, and pet dander, exercise, and strong emotions. This can lead to variable and episodic symptoms and increase the risk for asthma exacerbations, or “attacks”.

The diagnosis of asthma is typically first considered when patients experience characteristic symptoms of wheezing, cough, chest tightness or shortness of breath. Methods often employed to diagnose asthma include a detailed medical history and physical examination, as well as breathing tests (spirometry) to document airflow obstruction that reverses with a short-acting bronchodilator. Depending on the patient’s history, other tests including a chest X-ray and allergy tests may be considered.

Treatment of asthma focuses on controlling airway inflammation and relieving acute narrowing (constriction) of the airways when it occurs. A number of different drugs are considered to be controller agents, including inhaled and oral corticosteroids, leukotriene modifiers and long-acting beta-agonists. All patients with persistent asthma require at least one controller medication, while also employing short-acting inhaled bronchodilators (such as albuterol) when episodic constriction and obstruction occur. It has recently been recognized that a significant proportion (up to 50%) of asthmatics have non-allergic asthma and this has important implications for treatment, particularly response to anticholinergic medications. Education about avoidance of triggers and appropriate medication use are also important, as is involving all members of the care team in a comprehensive management approach.

Four Facts About Asthma and Allergy

  1. More than 25 million children (1 in 11) and adults (1 in 12) live with asthma, making it one of the most common and costly diseases. 

  2. Each year, over 3000 US asthma deaths occur. Low income and minority children bear the heaviest burden of asthma, including death.

  3. An estimated 50 million Americans suffer from all types of allergies (1 in 5 Americans) including indoor/outdoor, food & drug, latex, insect, skin and eye allergies.

  4. Allergy is the 5th leading chronic disease in the U.S. among all ages, and the 3rd most common chronic disease among children under 18 years old.