COPD vs. Asthma: What Is the Difference?

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

COPD vs. asthma quick comparison

  • COPD is mainly due to damage caused by smoking, while asthma is due to an inflammatory reaction.
  • COPD is a progressive disease, while allergic reactions of asthma can be reversible.
  • Initial symptoms can be similar in both diseases, for example, shortness of breath, chest tightness, wheezing, and cough, which can lead to confusion or misdiagnosis.
  • Both diseases can have severe, dangerous signs and symptoms, for example, a bluish discoloration of the skin, and respiratory distress. Death may even occur.
  • Initial treatments of COPD include bronchodilators, while initial treatments for asthma include inhaled corticosteroids while initial treatments.
  • COPD usually develops after age 40 and often becomes a chronic disease of lung function. Asthma may develop in people of almost any age.

What is COPD?

COPD (chronic obstructive pulmonary disease) is a lung disease caused by chronic interference with lung airflow that impairs breathing, and is not fully reversible. Usually symptoms, for example, shortness of breath, recurrent coughing, clearing throat, and progressive exercise tolerance, worsen over time. Many doctors and researchers (for example, the World Health Organization) consider terms such as chronic bronchitis and emphysema as forms of COPD. The major cause of COPD is smoking.

What is asthma?

Asthma is a respiratory condition marked by spasms of the bronchi, due to inflamed and narrowed airways in the lungs. Asthma causes difficulty in breathing that often results from an allergic reaction. Many substances may trigger asthma attacks. Asthma usually causes recurring periods of shortness of breath, wheezing and/or chest tightness. Often, asthma can be fully reversible with medical treatment and breathing can return to normal.

Symptoms and signs: 6 similarities between COPD vs. asthma

Similarities in signs and symptoms are between the two conditions are:

  1. Coughing
  2. Shortness of breath
  3. Chest tightness
  4. Exercise intolerance
  5. Wheezing (a whistling or squeaking sound in the chest)
  6. Anxiety with increased heart rate may occur in both diseases.

Symptoms and signs: 6 Differences between COPD vs. asthma

  1. In asthma, breathing can return to normal between attacks, while breathing with COPD usually does not return to normal.
  2. The symptoms of COPD gradually become more severe. (This also may occur if you have asthma.)
  3. COPD produces more mucus and phlegm compared to asthma.
  4. Chronic cough is common with COPD.
  5. People with COPD often have chronic blueness to fingernail beds and/or lips (cyanosis).
  6. Asthma can occur in a person of almost any age, while COPD usually occurs in those over age 40. (Although it is possible in some individuals to develop COPD a younger age.)

Causes of COPD vs. asthma

COPD is caused by long-term exposure to lung irritants that damage lung cells. The main cause of COPD in the United States is cigarette smoke followed by other tobacco smoke (including second hand smoke). Other possible causes of COPD include chemical or toxic fumes, and inherited (genetic) factors, like alpha-1 antitrypsin deficiency, but these causes are far less common than cigarette smoking.

Although cigarette smoke may trigger asthma in some patients, asthma triggers are different from person to person, and most commonly include airborne substances such as pollen, dust, mites, mold spores, pet dander, and/or many other substances. Inflammatory immune reactions to asthma triggers in the airways is the main cause of asthma.

What are the stages of COPD?

Doctors generally use the Global Initiative for Chronic Obstructive Lung Disease Program (GOLD) to stage COPD. These staging guidelines have been proven to be consistent and accurate by doctors and scientists. Other methods can be used to stage COPD, but they may be influenced by other factors.

COPD vs. asthma treatment guidelines and management

There are many treatment options and ways to manage COPD. The newest 2017 guidelines emphasize the use of combined bronchodilators as first-line therapy for COPD. Doctors recommend vaccinations for people with the condition to decrease the risk of lower respiratory tract infections. Alterations in health-related behaviors (for example, stopping smoking) is emphasized. Spirometry measurements can help determine the extent of obstructive lung disease. As COPD progresses, oxygen therapy, especially if you have obstructive sleep apnea, may help improve your survival.

Like COPD, there are many treatment options and ways to manage asthma. Your primary care doctor and/or an allergist will discuss and suggest the best choice of treatment and management drugs for you. Medications used include corticosteroids, short acting beta agonists (for example, albuterol, or Poventil and other brand names), and occasionally anticholinergic medications for severe exacerbations.

Occasionally, for long-term treatment and management of asthma, doctors will prescribe long-acting anticholinergic medications (for example, salmeterol [Servent] and formoterol [Foradil]), corticosteroids, and/or other drugs combinations of drugs. You and your allergist may need to try different drugs to find the most effective treatment for your condition. Your doctor may recommend allergy shots (immunotherapy) if you have become desensitized to certain asthma triggers.

Emergency treatment of life-threatening asthma or COPD may involve intravenous corticosteroids, intubation, mechanical ventilation, and oxygen treatment until the crisis is resolved.

What is the prognosis and life expectancy for a person COPD vs. asthma?

The prognosis for COPD ranges from fair to poor and depends on how rapidly COPD advances over time. In general, individuals with COPD have a decrease in their lifespan according to research.

If you have asthma, the prognosis for most people ranges from fair to excellent, depending upon how well you can identify what triggers your attacks, and your response to medication.

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Medically Reviewed on 7/17/2017
References
REFERENCES:

Haelle, T. "COPD Guidelines Update Treatment, Management Options." Medscape. Updated: Feb 02, 2017.
<https://www.medscape.com/viewarticle/875351#vp_2>

Morris, M. "Asthma Treatment and Management." Medscape. Updated Apr 25, 2017.
<http://emedicine.medscape.com/article/296301-treatment>
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