Can Asthma Turn into COPD? Here's What Medical Experts Say

Chronic obstructive pulmonary disease (COPD) describes progressive pulmonary conditions, including chronic bronchitis or lung emphysema.

Meanwhile, asthma is an inflammatory disease frequently associated with allergies. COPD and asthma are two distinct clinical conditions; however, having asthma increases the risk of developing COPD.

Nevertheless, it does not mean that asthma will necessarily lead to COPD. Moreover, if you have asthma, you can reduce your chances of developing COPD.

Is it Possible to Develop COPD from Asthma?

Yes. Even though asthma does not necessarily lead to COPD, if you already have asthma, especially poorly controlled, the chances of developing COPD are much higher than a person without asthma.

A study conducted in 2018 revealed the presence of asthma among 12.6% of COPD patients, while COPD was present among 14.6% of asthmatic patients.

Asthma is a chronic respiratory condition accompanied by wheezing and shortness of breath and worsened after trigger exposure (e.g., pollen, exercise, infection, β-blockers).

Controlling these symptoms to the point when you no longer require short-acting β agonists – a “rescue” medication for quick relief – is the central strategy of your treatment.

Intense and frequent asthma symptoms (poorly controlled asthma) can permanently damage your lungs, which is one of the COPD risk factors.

Moreover, as asthma and COPD symptoms are similar, one can suffer from both conditions while having undiagnosed COPD. The overlap of these two conditions is called asthma-COPD overlap syndrome (ACOS).

Differentiating these two conditions is essential for you, as they have different prognoses and require different treatment approaches.

In addition to determining these two conditions, you will also learn how to minimize the risks of developing COPD if you already have asthma.

Why is Asthma Linked to Increased COPD Risk?

Asthma and COPD are different clinical conditions, sharing common risk factors and clinical characteristics. Asthma is mainly diagnosed during childhood or adolescence, while COPD often appears during the middle or later life.

Both are chronic conditions accompanied by airway inflammation and obstruction; however, the main difference lies in the reversibility of changes in the respiratory system.

While the block during asthma may be entirely resolved with or without medications, the COPD obstruction is progressive – it mainly worsens over time.

The development of COPD is associated with smoking, lung function decrease, and airway hyperresponsiveness (AHR). The latter is a genetic predisposition of individuals among whom the airways respond (e.g., obstruction, inflammation) to stimuli (e.g., cigarette smoke, air pollutants, pollen), in contrast to individuals with little or no response.

The AHR is also one of the main distinctive clinical characteristics of asthma. Also, poorly controlled asthma leads to decreased lung function. So, here you can see how asthma can demonstrate the necessary risk factors for developing COPD.

How Do You Know If Your Asthma Has Turned into COPD?

Although most asthmatic patients do not develop COPD, the chances of having COPD among asthmatic patients are higher than healthy individuals.

The overlap of these conditions is not diagnosed easily; moreover, patients with asthma may be completely unaware they have COPD.

Meanwhile, early diagnosis of COPD is essential, as it increases the chances of slowing down the intensity and frequency of respiratory symptoms.

Asthma-COPD Overlap Syndrome (ACOS)

ACOS patients experience clinical signs of asthma and COPD more intensely and frequently and have more reduced lung function than asthma or COPD alone. These clinical signs include:

• Frequent coughing;
• Frequent shortness of breath;
• Fatigue;
• Wheezing;
• Excess mucus.

Not responding to the treatment intended for asthma (e.g., inhaled corticosteroids) and more frequent hospitalizations and emergency room visits are other probable signs that, in addition to asthma, you have COPD.

Your physician should use specific diagnostic tests (e.g., imaging) to understand whether you have ACOS or not. Understanding this as early as possible is crucial to managing COPD’s progression effectively.

How to Prevent Asthma from Turning into COPD?

Despite the uncontrollable risk factors for ACOS (e.g., being female), there are certain things you can do to prevent asthma from turning into COPD:

• Smoking cessation;
• Proper asthma control;
• Avoiding air pollutants, including tobacco smoke;
• Periodic medical check-ups as required;
• Annual flu vaccination.

FAQs About COPD and Asthma

How often does asthma lead to COPD?

Adults with asthma have 12.5 times more likely to develop COPD than those without asthma.¹

Can untreated asthma cause COPD?

Asthmatic patients have a higher chance of developing COPD than individuals without asthma. However, if asthma is poorly controlled, which commonly is the case of not receiving proper treatment, the chances of developing COPD increase.

Is asthma-COPD overlap rare?

The distribution of ACOS varies from study to study. However, it should not be considered as rare.

How common is the asthma-COPD overlap?

The prevalence of ACOS in the general population varies from 0.3% to 0.5%. Interestingly, this number is between 3.2% and 51.4% among asthmatic patients, and 12.6% to 55.7% among COPD patients.²

Can you have COPD and asthma together?

Yes, you can have asthma and COPD together; however, it does not necessarily mean that your asthma will eventually become COPD.

Conclusion

Asthma and COPD are different clinical conditions, sharing common risk factors and clinical characteristics. Although most asthmatic patients do not develop COPD, the chances of having COPD among asthmatic patients are higher than healthy individuals. The overlap of these two conditions is called asthma-COPD overlap syndrome (ACOS).

The symptoms of ACOS are more intense and frequent than those of asthma or COPD alone. Nevertheless, if you already have asthma, there are specific actions you can take to prevent turning it into COPD.

References

1. Lebowitz MD, Knudson RJ, Burrows B. TUCSON EPIDEMIOLOGIC STUDY OF OBSTRUCTIVE LUNG DISEASESI: METHODOLOGY AND PREVALENCE OF DISEASE. Am J Epidemiol. 1975;102(2):137-152. doi:10.1093/OXFORDJOURNALS.AJE.A112141
2. Hosseini M, Almasi-Hashiani A, Sepidarkish M, Maroufizadeh S. Global prevalence of asthma-COPD overlap (ACO) in the general population: A systematic review and meta-analysis. Respir Res. 2019;20(1):1-10. doi:10.1186/S12931-019-1198-4/TABLES/4

About the Author

After working as a paramedic and emergency physician, Arno has already shifted into healthcare research and medical writing for five years. While working as Healthcare Programs Coordinator, his research topics include community health and organizational healthcare. Simultaneously Arno is involved in academic writing and uses blog posts as a platform to transfer knowledge to the general audience. Get to know him on LinkedIn