Asthma vs. COPD: How to Tell the Difference

Written by Joann Jovinelly and Rena Goldman | Published on May 22, 2015
Medically Reviewed by Healthline Medical Team on May 22, 2015

Why Asthma and COPD Are Often Confused

Chronic obstructive pulmonary disease (COPD) is a general term that describes progressive respiratory diseases like emphysema and chronic bronchitis. COPD is characterized by decreased airflow over time, as well as inflammation of the tissues that line the airway.

Asthma is usually considered a separate respiratory disease, but sometimes it’s mistaken for COPD. The two have similar symptoms. These symptoms include chronic coughing, wheezing, and shortness of breath.

According to the National Institutes of Health (NIH), around 24 million Americans have COPD. About half of them don’t know they have it. Paying attention to symptoms — especially in people who smoke, or even used to smoke — can help those with COPD get an earlier diagnosis. Early diagnosis can be crucial to preserving lung function in people with COPD.

About 40 percent of people who have COPD also have asthma. Asthma is considered a risk factor for developing COPD. Your chance of getting this dual diagnosis increases as you age.

Asthma or COPD? How to Tell the Difference

Asthma and COPD may seem similar, but taking a closer look at the following factors can help you tell to the difference between the two conditions.

Age

Airway obstruction occurs with both diseases. But the age of initial presentation is often the distinguishing feature between COPD and asthma. People who have asthma are typically diagnosed as children, as noted by Dr. Neil Schachter, medical director of the respiratory care department of Mount Sinai Hospital in New York. On the other hand, COPD symptoms usually show up only in adults over the age of 40 who are current or former smokers, according to the NIH.

Different Triggers

The spectrum of triggers that cause COPD versus asthma reactions are also different. Asthma is usually made worse by exposure to allergens, cold air, and exercise, while COPD aggravations are largely caused by respiratory tract infections such as pneumonia and the flu. COPD can also be made worse by exposure to environmental pollutants.

Symptoms

Despite these differences, COPD and asthma symptoms seem outwardly similar, especially the shortness of breath that characterizes both diseases. Airway hyper-responsiveness (when your airways are very sensitive to things you inhale) is a common feature of both asthma and COPD.

Comorbidities

Comorbidities are diseases and conditions that you have in addition to the main disease. Comorbidities for asthma and COPD are also often similar. They include:

  • high blood pressure
  • impaired mobility
  • insomnia
  • sinusitis
  • migraine
  • depression
  • stomach ulcers
  • cancer

One study found that more than 20 percent of COPD patients have three or more comorbid conditions.

Response to Treatment

Both COPD and asthma respond well to treatments like quitting smoking and airway-opening medications like bronchodilators. However, lung function is only fully reversible in people with asthma. A diagnosis of asthma along with COPD often means a faster decline in lung function as the COPD progresses. This is still the case even in people with mild forms of the disease.

Outlook

There is no cure for either condition, but you can still live comfortably with the correct treatments. Managing asthma properly with medications and avoiding allergens can prevent episodes and allow you to continue normal activities. Damage from COPD can’t be reversed, but treatment can help you to be more active and slow the disease’s progression.

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