Table of ContentsView AllTable of ContentsAirway RemodelingExercise IntoleranceLung InfectionsSleep ApneaGERDPregnancy RisksRespiratory FailurePrevention
Table of ContentsView All
View All
Table of Contents
Airway Remodeling
Exercise Intolerance
Lung Infections
Sleep Apnea
GERD
Pregnancy Risks
Respiratory Failure
Prevention
The long-term effects of asthma can undermine your quality of life and ability to participate in everyday activities. If poorly controlled,asthmacan cause structural changes to the lungs, leading to more frequent and severe asthma attacks and an increased risk ofpneumonia,respiratory failure, and evendeath.
Although asthma may never be completely cured, keeping it well-controlled with medications and lifestyle changes can prevent long-term damage and preserve the good health of your lungs.
Jessica Olah / Verywell
Uncontrolled Asthma and Airway Remodeling
Uncontrolled asthma exposes the airways of the lungs (called thebronchiandbronchioles) to high levels ofchronic inflammation. Over time, this can cause permanent changes to the lungs, known as airway remodeling, causing the lining of the bronchi and bronchioles to thicken and become less flexible.
These structural changes can lead to:
When this happens, a person may experience more frequent and violent asthma attacks. At the same time, medications used to treat asthma, such asinhaled bronchodilatorsandcorticosteroids, may be less able to control attacks and more likely to cause side effects.
Severe airway remodeling can lead to an irreversible condition calledbronchiectasisin which the airways become permanently widened.
Reduced Exercise Tolerance
With uncontrolled asthma, a person will almost invariably experience reducedexercise tolerance. This is when even mild to moderate levels of physical activity, like walking up stairs, can leave you breathless.
According to research published in theJournal of Clinical Medicine, people with severe asthma engage in considerably less physical activity than the average healthy adult—taking 31% fewer steps and engaging in 47.5% fewer minutes of physical activity per day.
Over time, a lack of activity can lead to an increased risk of metabolic and heart-related diseases like:
Increased Risk of Lung Infection
With uncontrolled asthma, a person is vulnerable tolung infections, including pneumonia. This is especially true in people who have experienced significant airway remodeling. In such cases, mucus can start to pool in the airways, creating a hotbed for bacterial growth.
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Obstructive Sleep Apnea
People with asthma have a greater risk of developingobstructive sleep apnea(OSA), a condition that causes long gaps in breathing during sleep.
On the flip side, OSA is linked to poor asthma control and more frequent asthma attacks during both the day and night. By controlling OSA with acontinuous positive airway pressure (CPAP) machine, asthma symptoms tend to improve.
Gastroesophageal Reflux Disease
For reasons that are not entirely clear,acid refluxcan worsen asthma symptoms and asthma can increase the risk of chronic acid reflux (commonly known asgastroesophageal reflux disease, or GERD).
In fact, studies suggest that nearly 80% of people with asthma have symptoms of GERD, while GERD is linked to a 1.15-fold increased risk of asthma.
Acid reflux may trigger asthma symptoms when the sudden onset of inflammation in theesophagus(feeding tube) “spills over” to smooth muscles of the airways. It is also possible that regurgitated acid might cause microaspiration (in which tiny amounts of stomach acid are breathed into the lungs).
Pregnancy Complications
According to the American College of Allergy, Asthma, and Immunology (ACAAI), asthma affects anywhere from 4% to 12% of females in their childbearing years. Of these, 4% to 8% will experiencepregnancy complications. This is especially true for those with severe asthma and/or who have a history of poor asthma control.
Pregnant people with severe asthma will typically experience a worsening of asthma symptoms during weeks 24 to 36 of gestation. Around 10% may even experience an attack during labor or delivery.
In severe cases, this has been known to contribute topreeclampsia(a potentially deadly rise in blood pressure),placental abruption, and even fetal or maternal death.
Respiratory failure is a serious condition that occurs when the lungs can’t get enough oxygen into the blood. People with asthma who experience significant airway remodeling are at risk, especially those with bronchiectasis.
In severe cases, this can lead to an extreme type of asthma attack known asstatus asthmaticus. With status asthmaticus, a person will experience a severe drop in blood oxygen (hypoxemia) and an extreme increase in carbon dioxide (hypercapnia), leading to acute respiratory distress. In extreme cases,respiratory arrest(in which breathing stops entirely) can occur.
In 2021, 3,517 peopledied from asthma, many from asthma-induced respiratory failure.
How to Avoid Asthma Complications
Asthma is a potentially reversible condition when the right treatment is received at the right time. Management plays a critical role in all of this, helping prevent the progression of thisobstructive lung disease.
To avoid long-term complications of poorly controlled asthma, speak with your healthcare provider to assess your current medications and lifestyle choices. Beyond changes in medications, you may benefit from lifestyle changes such as:
Summary
If asthma is poorly controlled, it can lead to long-term complications like airway remodeling, reduced exercise tolerance, an increased risk of lung infections, obstructive sleep apnea, GERD, and respiratory failure. It can also contribute to pregnancy complications like preeclampsia and pregnancy loss.
To avoid such complications, speak with your healthcare provider if asthma attacks are frequent or severe. Changes in medications and lifestyle may help reduce the frequency and severity of attacks, preventing long-term damage to the lungs.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fehrenbach H, Wagner C, Wegmann M.Airway remodeling in asthma: what really matters.Cell Tissue Res. 2017;367(3):551-569. doi:10.1007/s00441-016-2566-8National Heart, Lung, and Blood Institute.Bronchiectasis causes and risk factors.Panagiotou M, Koulouris NG, Rovina N.Physical activity: A missing link in asthma care.J Clin Med. 2020;9(3), doi:10.3390%2Fjcm9030706Kreslova M, Kirchnerova O, Rajdi D, et al.Bronchial asthma as a cardiovascular risk factor: a prospective observational study.Biomedicines. 2022 Oct;10(10):2614. doi: 10.3390/biomedicines10102614Lee YJ, Park YB.Inhaled corticosteroids is not associated with the risk of pneumonia in asthma.Tuberc Respir Dis (Seoul). 2023 Jul;86(3):151–157. doi:10.4046/trd.2022.0147Chung WS, Lin CL.Acute respiratory events in patients with bronchiectasis–COPD overlap syndrome: a population-based cohort study.Respiratory Med. 2018;140:6-10. doi:10.1016/j.rmed.2018.05.008Dixit R.Asthma and obstructive sleep apnea: more than an association.Lung India. 2018;35(3):191-192. doi:10.4103/lungindia.lungindia_241_17Ates F, Vaezi MF.Insight into the relationship between gastroesophageal reflux disease and asthma.Gastroenterol Hepatol (N Y).2014 Nov;10(11):729–736.American College of Allergy, Asthma, and Immunology.Pregnancy and asthma.American Lung Association.Asthma and pregnancy.Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258American Lung Association.Asthma trends and burden.American College of Allergy, Asthma, and Immunology.Asthma-COPD overlap.National Heart, Lungs, and Blood Institute.Asthma: managing asthma.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fehrenbach H, Wagner C, Wegmann M.Airway remodeling in asthma: what really matters.Cell Tissue Res. 2017;367(3):551-569. doi:10.1007/s00441-016-2566-8National Heart, Lung, and Blood Institute.Bronchiectasis causes and risk factors.Panagiotou M, Koulouris NG, Rovina N.Physical activity: A missing link in asthma care.J Clin Med. 2020;9(3), doi:10.3390%2Fjcm9030706Kreslova M, Kirchnerova O, Rajdi D, et al.Bronchial asthma as a cardiovascular risk factor: a prospective observational study.Biomedicines. 2022 Oct;10(10):2614. doi: 10.3390/biomedicines10102614Lee YJ, Park YB.Inhaled corticosteroids is not associated with the risk of pneumonia in asthma.Tuberc Respir Dis (Seoul). 2023 Jul;86(3):151–157. doi:10.4046/trd.2022.0147Chung WS, Lin CL.Acute respiratory events in patients with bronchiectasis–COPD overlap syndrome: a population-based cohort study.Respiratory Med. 2018;140:6-10. doi:10.1016/j.rmed.2018.05.008Dixit R.Asthma and obstructive sleep apnea: more than an association.Lung India. 2018;35(3):191-192. doi:10.4103/lungindia.lungindia_241_17Ates F, Vaezi MF.Insight into the relationship between gastroesophageal reflux disease and asthma.Gastroenterol Hepatol (N Y).2014 Nov;10(11):729–736.American College of Allergy, Asthma, and Immunology.Pregnancy and asthma.American Lung Association.Asthma and pregnancy.Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258American Lung Association.Asthma trends and burden.American College of Allergy, Asthma, and Immunology.Asthma-COPD overlap.National Heart, Lungs, and Blood Institute.Asthma: managing asthma.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fehrenbach H, Wagner C, Wegmann M.Airway remodeling in asthma: what really matters.Cell Tissue Res. 2017;367(3):551-569. doi:10.1007/s00441-016-2566-8National Heart, Lung, and Blood Institute.Bronchiectasis causes and risk factors.Panagiotou M, Koulouris NG, Rovina N.Physical activity: A missing link in asthma care.J Clin Med. 2020;9(3), doi:10.3390%2Fjcm9030706Kreslova M, Kirchnerova O, Rajdi D, et al.Bronchial asthma as a cardiovascular risk factor: a prospective observational study.Biomedicines. 2022 Oct;10(10):2614. doi: 10.3390/biomedicines10102614Lee YJ, Park YB.Inhaled corticosteroids is not associated with the risk of pneumonia in asthma.Tuberc Respir Dis (Seoul). 2023 Jul;86(3):151–157. doi:10.4046/trd.2022.0147Chung WS, Lin CL.Acute respiratory events in patients with bronchiectasis–COPD overlap syndrome: a population-based cohort study.Respiratory Med. 2018;140:6-10. doi:10.1016/j.rmed.2018.05.008Dixit R.Asthma and obstructive sleep apnea: more than an association.Lung India. 2018;35(3):191-192. doi:10.4103/lungindia.lungindia_241_17Ates F, Vaezi MF.Insight into the relationship between gastroesophageal reflux disease and asthma.Gastroenterol Hepatol (N Y).2014 Nov;10(11):729–736.American College of Allergy, Asthma, and Immunology.Pregnancy and asthma.American Lung Association.Asthma and pregnancy.Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258American Lung Association.Asthma trends and burden.American College of Allergy, Asthma, and Immunology.Asthma-COPD overlap.National Heart, Lungs, and Blood Institute.Asthma: managing asthma.
Fehrenbach H, Wagner C, Wegmann M.Airway remodeling in asthma: what really matters.Cell Tissue Res. 2017;367(3):551-569. doi:10.1007/s00441-016-2566-8
National Heart, Lung, and Blood Institute.Bronchiectasis causes and risk factors.
Panagiotou M, Koulouris NG, Rovina N.Physical activity: A missing link in asthma care.J Clin Med. 2020;9(3), doi:10.3390%2Fjcm9030706
Kreslova M, Kirchnerova O, Rajdi D, et al.Bronchial asthma as a cardiovascular risk factor: a prospective observational study.Biomedicines. 2022 Oct;10(10):2614. doi: 10.3390/biomedicines10102614
Lee YJ, Park YB.Inhaled corticosteroids is not associated with the risk of pneumonia in asthma.Tuberc Respir Dis (Seoul). 2023 Jul;86(3):151–157. doi:10.4046/trd.2022.0147
Chung WS, Lin CL.Acute respiratory events in patients with bronchiectasis–COPD overlap syndrome: a population-based cohort study.Respiratory Med. 2018;140:6-10. doi:10.1016/j.rmed.2018.05.008
Dixit R.Asthma and obstructive sleep apnea: more than an association.Lung India. 2018;35(3):191-192. doi:10.4103/lungindia.lungindia_241_17
Ates F, Vaezi MF.Insight into the relationship between gastroesophageal reflux disease and asthma.Gastroenterol Hepatol (N Y).2014 Nov;10(11):729–736.
American College of Allergy, Asthma, and Immunology.Pregnancy and asthma.
American Lung Association.Asthma and pregnancy.
Agnihorri NT, Saltoun C.Acute severe asthma (status asthmaticus).Allergy Asthma Proc.2019 Nov 1;40(6):406-409. doi:10.2500/aap.2019.40.4258
American Lung Association.Asthma trends and burden.
American College of Allergy, Asthma, and Immunology.Asthma-COPD overlap.
National Heart, Lungs, and Blood Institute.Asthma: managing asthma.
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