Asthma is a complex disease that is influenced by multiple
genetic, developmental, and environmental factors, which interact to
produce the overall condition.
Asthma Treatment
The most effective treatment for
asthma is identifying triggers, such as pets or aspirin, and
limiting or eliminating exposure to them. Desensitization is commonly
attempted, but has not been shown to be effective. As is common with
respiratory disease, smoking adversely affects asthmatics in several
ways, including an increased severity of symptoms, a more rapid decline
of lung function, and decreased response to preventive medications.
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Asthma patients who smoke
typically require additional medications to help control their disease.
Furthermore, exposure of both nonsmokers and smokers to secondhand smoke
is detrimental, resulting in more severe asthma, more emergency room
visits, and more asthma-related hospital admissions. Smoking cessation
and avoidance of those who smoke is strongly encouraged in asthmatics.
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Asthma Prognosis
The prognosis for asthma patients is
good, especially for children with mild disease. For asthmatics
diagnosed during childhood, 54% will no longer carry the diagnosis after
a decade. The extent of permanent lung damage in asthmatics is unclear.
FLU
SYMPTONS
Airway remodeling is observed, but it
is unknown whether these represent harmful or beneficial changes.
Although conclusions from studies are mixed, most studies show that
early treatment with glucocorticoids prevents or ameliorates decline in
lung function as measured by several parameters.
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For those who continue to suffer from
mild symptoms, corticosteroids can help most to live their lives with
few disabilities. The mortality rate for asthma is low, with around 6000
deaths per year in a population of some 10 million patients in the
United States. Better control of the condition may help prevent some of
these deaths.
Asthma and athletics
Asthma appears to be more
prevalent in athletes than in the general population. One survey of
participants in the 1996 Summer Olympic Games showed that 15% had been
diagnosed with asthma, and that 10% were on asthma medication. These
statistics have been questioned on at least two bases. Persons with mild
asthma may be more likely to be diagnosed with the condition than others
because even subtle symptoms may interfere with their performance and
lead to pursuit of a diagnosis. It has also been suggested that some
professional athletes who do not suffer from asthma claim to do so in
order to obtain special permits to use certain performance-enhancing
drugs.
There appears to be a relatively high incidence of asthma in
sports such as cycling, mountain biking, and long-distance running, and
a relatively lower incidence in weightlifting and diving. It is unclear
how much of these disparities are from the effects of training in the
sport, and from self-selection of sports that may appear to minimize the
triggering of asthma.
In addition, there exists a variant of asthma called exercise-induced
asthma that shares many features with allergic asthma. It may occur
either independently, or concurrent with the latter. Exercise studies
may be helpful in diagnosing and assessing this condition.
Asthma Death Rates
Higher for Minorities
(FDA)
Black Americans have only a slightly
higher prevalence rate of asthma than whites (8.5 percent versus
7.1 percent), but blacks are three times more likely to die or be
hospitalized because of the disease. According to the Centers for
Disease Control and Prevention, while asthma mortality rates have gone
down overall since 1995, racial disparities remain.
Floyd Malveaux, M.D., dean of Howard University's College of Medicine in
Washington, D.C., says the reasons are complex. "We know that this is
one of many diseases in which minorities and underserved populations are
disproportionately affected," he says. "A lot of the disparities are
related to poverty."
Malveaux says lack of access to care plays a large role. "It's not just
about having health insurance," he says, "but also about whether there
is access to transportation and knowing how to use the health care
system. There may be no access to asthma specialists, perhaps because of
limitations in managed care. So then what you have is a reactive
situation and a lot of emergency room visits versus a proactive
situation that focuses on prevention."
He also points out that when you're living in poverty you can't control
the environment like you may want to. "I think of an area in Detroit
where big diesel trucks come across from Canada," he says. "You can see
the line of trucks emitting diesel fuel in a poor neighborhood, and the
people who live there can't control that."
Other factors may be the challenge of paying for asthma medications and
exposure to smoking and cockroaches. Research supported by the National
Institute of Allergy and Infectious Diseases has found that children in
inner-city areas who were both allergic to cockroaches and heavily
exposed to them had higher rates of hospitalization for asthma, missed
school more often, and suffered more sleep loss.
Hispanics also have higher death rates from asthma compared with whites,
with Puerto Ricans experiencing the highest burden.
More information on Asthma
Inhalers, Asthma Bronchial Treatment and Asthma Sign and Symptoms
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