The Definitive Differences Between Asthma and COPD

Quincy AdamCOPD Learn

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On the surface, asthma and chronic obstructive pulmonary disease (COPD) may seem similar. Both can cause shortness of breath, wheezing and coughing. But there are key differences between asthma and COPD—including different causes, different ages of onset, and different prognoses (expected results).

Below are some basic differences:

  • Emphysema-caused COPD is a loss of elasticity in lungs
  • COPD from chronic bronchitis leads to a thickening of airways that makes it difficult to breathe
  • COPD is a lung1 As smoking and chemical toxins irritate and inflame bronchial tissues, a type of white blood cells (called neutrophils) attacks and destroy irritants but in the process, they permanently scar lung tissue
  • In asthma, it is the large airways in the lungs that constrict in response to a triggering event (such as extreme cold air or allergen) that makes it difficult to breathe. In allergic asthma, a different type of white blood cells (called eosinophils) is released to fight allergens

While asthma and COPD are different diseases, it is possible to have both conditions. This is particularly true if you are a smoker. A large number of COPD patients also have asthma.2

Different Demographics?

  • COPD: Typically older adults (after age 40), most of whom are or were smokers, are diagnosed with COPD.3
  • Asthma: Onset can come at any age, although it is often diagnosed in childhood or the young adult years4. It can affect both smokers and nonsmokers.

Different Causes?

  • COPD: A non-allergic response to cigarette smoke, inhaled toxins, long-term exposure to toxic substances in the workplace (most often chemical fumes), air pollution, and some genetic factors.
  • Asthma: Both allergic and non-allergic responses to environmental substances, weather, exercise and stress.

Different Symptoms?

  • COPD: This is a chronic condition that will impact daily life and become worse over time. In the early stages, it is typical to start the day by coughing to clear your lungs of phlegm and mucus. In later stages, it may require oxygen therapy and other treatments to deal with shortness of breath. A related condition may be congestive heart failure.
  • Asthma: While flare-ups occur and can be either intermittent or persistent and sometimes acute, this is a condition that typically responds well to proper Wheezing and breathing difficulties are typical of a flare-up. Coughing and wheezing may be worse at night. Symptoms sometimes associated with asthma include other allergy-related conditions and even gastroesophageal reflux.

Different Treatments?

  • COPD: Treatments include inhaled bronchodilators, inhaled corticosteroids and lifestyle changes.
  • Asthma: While asthma patients may use many of the same medications as COPD patients, it is important to note that not all asthma medications will help manage COPD symptoms.

Different Prognoses?

  • COPD: This is a progressive disease that results in loss of lung function due to inflammation that damages lung tissue and airways in the lungs. At this time, COPD cannot be stopped, or the lung damage reversed—even with treatment.5
  • Asthma: Inflammation is variable and often responds well to treatment and medications. In many cases, lung function is reversible with the right treatment.

The bottom line is that the definitive differences between asthma and COPD are:

  • COPD is a progressive and irreversible disease of the lungs that is most closely associated with heavy smoking although extreme or long-term exposure to chemical fumes can also cause it.
  • Asthma is a respiratory tract response to environmental allergens, pollen, dust and air pollution as well as weather, exercise and stress. It is often prevalent in children and adolescents. Also, asthma does not cause lung damage.

1 Jennifer Kathleen Quint, Jadwiga Anna Wedzicha, MD. The neutrophil in chronic obstructive pulmonary disease. The Journal of Allergy Clinical Immunology. May 2007; Volume 119, Issue 5, Pages 1065–1071.2 Megan Hardin, Edwin K Silverman, Graham Barr, Nadia N Hansel, Joyce D Schroeder, Barry J Make, James D Crapo, Craig P Hersh. The clinical features of the overlap between COPD and asthma. 2011; 12(1): 127. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204243/?tool=pmcentrez

3 CDC. Chronic Obstructive Pulmonary Disease. http://www.cdc.gov/copd/maps/docs/pdf/NE_COPDFactSheet.pdf. Accessed 7.23.16.

4 KidsHealth. Wheezing and Asthma in Infants. http://kidshealth.org/en/parents/wheezing-asthma.html. Accessed 7.23.16.

5 Virender P. Singh Rathod et al, “Assessment of Asthma and Chronic Obstructive Pulmonary Disorder in Relation to Reversibility, IgE, Eosinophil, and Neutrophil Count in a University Teaching Hospital in South Delhi, India,” Journal of Pharmacy & Bioallied Sciences, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996067/ (October/December 2010).