Can Asthma Increase COPD Risk?


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As many as 1 in 10 children in the U.S. have asthma, a lung condition that is responsible for one-quarter of all emergency room visits each year. About 1 in 20 adults have chronic obstructive pulmonary disease (COPD), which is the fourth leading cause of death in the U.S.

Experts think the two lung conditions are unrelated, although both can cause coughing, shortness of breath, and other symptoms that respond to airway-relaxing drugs, known as bronchodilators.

But could there be a link? A recent study by researchers in Australia found that more than 40% of children with severe asthma developed COPD by the age of 50—a 32-fold higher risk compared to asthma-free children. The researchers followed nearly 200 children beginning at age 7.

“This certainly raises the point that early and aggressive treatment of asthma may indeed prevent the development of COPD later in life,” says Robert Wise, MD, a professor of environmental health sciences at the Johns Hopkins University School of Medicine, in Baltimore.

But it’s too early to be sure, Dr. Wise says.

What is COPD?
Experts believe that in some people, asthma—particularly severe asthma—raises the risk of COPD later in life. Asthma, an inflammatory condition, can thicken the walls of lung airways and narrow air passages, a process known as remodeling.

“I suspect that this remodeling of the airway may be part of what leads to fixed airflow obstruction in COPD,” says Dr. Wise.

COPD includes two conditions, emphysema and chronic bronchitis, and is often, but not always, caused by smoking. About 1 in 4 long-term smokers will get COPD, if they live long enough. Other causes of COPD include secondhand smoke, workplace exposure to dust and pollutants, and a rare genetic condition. All of these may damage the lungs and dramatically speed up a process that happens in all people—a loss of lung function with age.

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