Asthma is a chronic condition that occurs when airways become inflamed and respond to irritating substances or allergens by narrowing. When this happens, less air reaches your lungs.
If someone in your family has the condition, you are at greater risk for it. Asthma is more likely to appear during childhood, but it can first show up in your 50s, 60s, or even later. So-called adult-onset asthma is more common in women, and usually affects people who develop sensitivity to a substance. According to the Asthma and Allergy Foundation of America, about 30 percent of asthma cases in adults are allergy-related. People with cat allergies are especially vulnerable. But if you are prone to any allergies, you may be vulnerable.
Now a meta-analysis recently published in the American Journal of Respiratory and Critical Care Medicine suggests another trigger for adult-onset asthma: being overweight or obese. While weighing more than you should has previously been implicated as a risk factor for the condition, Colorado researchers found that the more a person weighs, the greater the risk for asthma. According to the researchers, the incidence of asthma increases by 50 percent in people who are overweight or obese. If these same people lost significant amounts of weight, the researchers maintain, the number of new asthma cases in the United States might drop by as many as 250,000 per year.
Lots of things can trigger symptoms, including allergens such as pollen or pet dander; mold; cockroach droppings; dust; and foods such as shellfish or the sulfites in dried fruit and red wine. Also on the list are irritants such as cigarette smoke, perfume and scented household sprays or detergents. Even exercise or activities that make you breathe harder, such as laughing or crying, can bring on an asthma attack. So can a cold, a bout of the flu or a sinus infection; dry wind or cold air; and medication such as aspirin.
The result: hallmark symptoms of asthma such as wheezing, thick mucus production, tightness in the chest, coughing, and trouble breathing. Often, symptoms flare up during the night or in the early morning. In extreme cases, asthma can cause death. Each year, about 5,000 people die from the condition in the U.S.
To test your lung function, your doctor may have you take a deep breath and exhale into a device called a spirometer. The amount of air you blow out and the speed with which you do it may be lower than what’s considered normal if your airways are inflamed or narrowed. If that’s the case, you may be asked to use an asthma medication and then repeat the test to see if the medication has helped.
Another breath-strength gauge consists of exhaling with as much force as possible into a hand-held device called a peak flow meter.
Asthma treatment generally has two goals: one is to keep the asthma from flaring up; the other is to manage attacks once they occur. Quick-relief, or rescue, medicines are short-acting and belong to a class of drugs called inhaled beta-agonists, such as albuterol, or bronchodilators, which relax the walls of the airways, enabling easier breathing. Taken at the first sign of an asthma attack, they are designed to stop symptoms before they worsen.
The other category of asthma medicine is aimed at controlling symptoms over the long term. The medicines include inhaled corticosteroids to reduce inflammation (and sometimes a steroid tablet or liquid); inhaled long-acting beta-agonists, such as salmeterol (Serevent); leukotriene modifiers, such as montelukast (Singulair); cromolyn (Intal); nedocromil (Tilade); and theophylline (Theodur). Some medicines are taken singly; others may be paired with an inhaled corticosteroid, such as methylprednisolone (Medrol), for best results. If you are taking drugs for other health problems, make sure your doctor knows—some drugs can interfere with asthma medicine and even cause an attack. Steroids also can affect bone density, so discuss bone-saving strategies, such as getting enough calcium and vitamin D, with your doctor.
Treatment may also involve monitoring your lung function with a peak flow meter at home. By tracking your peak flow, you can gauge if your symptoms are under control or even if an asthma attack is imminent. DM