Asthma Control vs. Asthma Severity: What You Need to Know

by John Bottrell Health Professional

How severe is your asthma?
Is it under control?
Does it matter?
It seems the new recommendation is that asthma severity is out and asthma control is in.
So what does that me for me and you?

To help us decide I think a few definitions from
The National Heart, Blood and Lung Institute's Asthma Guidelines
are in order here:

Asthma Severity:
This is basically how bad your asthma is BEFORE you are on any asthma medicines, or how bad your asthma would be if you quit taking your asthma controller medicine.

The level of severity is best assessed when you are first diagnosed with asthma, and it helps your doctor determine the future course of therapy that will work best for you. This is generally measured to initiate asthma therapy.

The levels of severity are generally classified as:

  • Intermittent

  • Mild persistent

  • Moderate persistent

  • Severe persistent

The problem most doctors have with diagnosing severity is
most patients are already on asthma medicine before they are seen, so determining severity by the above definition is pretty much a guessing game.

If you're like me you'd love to know how severe your asthma is, yet you won't want to quit taking your athma controller medicine to find out.

Asthma Control:
This is basically a measure of how normal your life is compared to other people your age.
It's measured once you are on asthma controller medicine and
measures of how well your asthma therapy reduces asthma symptoms and impairments.

Control is generally measured to adjust your asthma regime. By measuring this at your doctor visits your doctor may tweak your medicine regime and/ or your asthma action plan, or keep things as they are.

It's measured by:

  • The degree your symptoms are minimized (short of breath, wheezing, etc.)

  • The degree your impairments are minimized (ability to exercise, walk, live a normal, active life)

  • The degree to which your goals of therapy are met (I'm
    able to exercise without limitations.
    No school or work days missed.)

According to the Global Initiative For Asthma (GINA) asthma guidelines, the classifications of asthma control are:

  • Controlled

  • Partly controlled

  • Uncontrolled

To learn how to tell if
your asthma is controlled click, or you can click here to download a neat pocket
guide created by GINA that defines controlled, partly controlled and uncontrolled asthma.

So it's neat to know how severe your asthma is, yet experts have learned that monitoring level of control is a better way of monitoring your asthma status and adjusting your asthma meds as needed.

Still, regardless of how severe your asthma is, by
being asthma smart most asthmatics can obtain good asthma control.

John Bottrell
Meet Our Writer
John Bottrell

John Bottrell is a registered Respiratory Therapist. He wrote for HealthCentral as a health professional for Asthma and Chronic Obstructive Pulmonary Disease (COPD).