By Malcolm Blumenthal, M.D.
Asthma is increasing at such a rapid rate, some are calling it an epidemic. This common disease probably affects some 7 to 12 percent of the U.S. population during their lifetimes. But for the last 30 years, it has been on the rise, especially in core cities, where 15 to 20 percent of residents might suffer from the shortness of breath, wheezing, and coughing that characterize asthma.
In addition, death rates from asthma rose 58 percent overall in a recent 12-year period. Children 19 years and younger have been most affected, with their death rates from asthma rising, according to the Asthma and Allergy Foundation of America. The chronic disease also disproportionately affects Hispanics and African-Americans.
As dire as these statistics are, there is good news: Asthma is a manageable disease. In order to get it under control, it's first of all important to understand what asthma is. If someone shows symptoms, such as being out of breath, that person needs to see a health professional for a diagnosis. Asthma might, or might not, be the cause. Once asthma is diagnosed, triggers can be identified and avoided and a physician can prescribe the appropriate medications to treat an individual.
Asthma, by definition is inflammation of the lungs characterized by three symptoms: coughing, wheezing, and shortness of breath. But having one, two, or three of the symptoms is not enough to determine whether it's asthma. We all cough sometimes and we all don't have asthma. If someone coughs and wheezes, chances increase that he or she may have asthma. Adding being short of breath to the list, however, is not definitive: the person may be overweight or out of condition.
A health professional can separate out whether it's asthma or not by testing the lungs' ability to function. A test will show whether the person has an airway obstruction that's reversible and bronchial passages in the lungs that are particularly sensitive (hyperreactive) to chemicals such as histamine or hethacholine irritants, air pollutants, or allergens.
That sensitivity may be inherited. But the increase in asthma among inner city residents is probably not due to genetics parents passing the tendency to children because the change is happening too quickly. Rather, it's probably caused by greater exposure to triggers like air pollution, cigarette smoke, dust dander, mites, and cockroaches. Lack of access to health care may add to the problem.
Nowadays, we feel asthma may cause permanent damage, what we call airway remodeling. In view of this, you really want to get it early and try to prevent any of the permanent, irreversible damage. With the proper treatment, the right medication and by avoiding triggers, asthma patients can breathe easy again.
Malcolm Blumenthal, M.D., is a professor of medicine at the University of Minnesota. This is an educational service and advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to
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