Medical Edge Newspaper Column

Other Health Conditions Can Aggravate Asthma Symptoms

May 14, 2006
DEAR MAYO CLINIC:
I was diagnosed with bronchial asthma when I was 11. I had the attacks weekly through most of my teen years. As I got older, the attacks diminished until I was almost asthma-free from age 28 to 59. Then I began to develop a steady chronic condition again. Now I'm 83 and on several medications for asthma, including Advair, Lotensin, Levoxyl and hydrochlorothiazide. Are medications the only treatment options? -- Vashon, Wash.

ANSWER:
Your situation isn't surprising. Asthma can worsen or improve throughout a person's lifetime. While it's often thought of as a disease starting in childhood, it can develop at any age. About 20 million Americans have asthma; an estimated 6.2 million of them are children.

For an older adult, managing asthma is increasingly complicated if you have other health problems, too. Hypertension, heart disease, gastroesophageal reflux disease and other conditions can cause chest symptoms that are similar to those of asthma. These health conditions can make asthma symptoms worsen. Medications for other health problems can interplay with asthma medications. For both physician and patient, determining what is causing the symptoms and which treatments are effective can be difficult.

From what you've shared, it appears you do have other health problems. Of the medications you mentioned, only Advair (fluticasone/salmeterol combination inhaler), which contains an inhaled corticosteroid, is an asthma medication. The others are used for various conditions, including thyroid disorders (levothyroxine/Levoxyl), high blood pressure (hydrochlorothiazide, benazepril/Lotensin) and heart disease (benazepril/Lotensin).

At your age and with multiple health concerns, your best bet for managing your asthma is to work with a doctor who can care for the whole person -- that is, manage treatment for all your health conditions and ensure that medications work effectively together. A primary care physician or internal medicine specialist could fill this role and regularly review all aspects of your care.

Medications likely will remain part of your asthma treatment program to control chronic symptoms and prevent asthma attacks.

There are other steps you can take to improve your asthma if you haven't already. If you smoke, stop. Smoking worsens asthma symptoms. If your asthma is related to allergies, find ways to minimize your exposure to allergy triggers.

-- James Li, M.D., Ph.D., Allergic Diseases, Mayo Clinic, Rochester, Minn.