Background

Asthma affects 100 people per 100,000 older than 20 years of age.  Its symptoms include coughing, wheezing, and shortness of breath with or without exercise intolerance.  Asthma can be deadly if undertreated or unrecognized.

20% of adult asthma patients enter a remission period.  Remission does not occur in long-standing asthma or in those with reduced lung function at the time of diagnosis (indicating established lung airway disease).  Asthma beginning after age 50 is more severe and less reversible than in children.  Smoking doubles the severity of asthma.

Factors that correlate with persistence or recurrence of childhood asthma:

• onset before age 3 years
• female sex
• higher disease severity
• active and passive
  tobacco exposure

Symptoms < 2 times a week

Symptoms > 2 times a week, less than 1 time per day

Daily Symptoms

Continual Symptoms

Exacerbations brief (hours to days)

Exacerbations affect activity

Exacerbations affect activity and >2 times a week

Frequent Exacerbations

No symptoms between attacks

Use of a rescue inhaler required >2 times a week

Daily use of  a rescue inhaler (albuterol) required

Limited physical activity possible

Nighttime symptoms < 2 times a month

Nighttime symptoms > 2 times a month

Nighttime symptoms > 1 time a week

Nighttime symptoms frequent