World Asthma Day 2023: Risk Factors Of Asthma, And Comorbidities That Aggravate The Disease


World Asthma Day: Asthma, a major non-communicable, inflammatory disease affecting both children and adults, is caused by exposure to environmental irritants such as pollen, mold spores, dust mites, pet dander, and smoke, or through excessive stress and physical activity. The disease is characterised by constricted airways where excessive mucus is produced. 

This makes it difficult for the affected person to breathe, and causes them to cough frequently, suffer from shortness of breath, and make a wheezing sound while exhaling. 

Risk factors and complications of asthma

The risk factors of asthma include a family history of the disease, obesity, smoking, and exposure to allergens, secondhand smoke, and occupational triggers. 

The complications of asthma include difficulty sleeping, a permanent narrowing of bronchial tubes, and side effects from medications for the disease, according to Mayo Clinic. 

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A combination of genetic and environmental factors results in asthma. 

“Genetic factors play a significant role in the development of asthma. Studies have shown that asthma is more common in people who have a family history of the condition. Several genes have been linked to asthma, including genes that regulate immune system function and genes that control airway responsiveness,” Dr Shahid Shafi, Consultant Internal Medicine, Ujala Cygnus Group of Hospitals, told ABP Live.

Exposure to triggers causes inflammation in the airways of asthmatics, due to a response of the immune system. 

“This inflammation leads to swelling and narrowing of the airways, making it difficult for air to pass through. This can cause symptoms such as wheezing, coughing, chest tightness, and shortness of breath,” Dr Shafi said.

When there is repeated exposure to triggers, chronic inflammation can occur in the airways, making it more difficult to control asthma symptoms.

“This is why it is important for asthmatic people to identify and avoid their triggers, as well as work with their doctor to develop a personalised treatment plan that includes medications and lifestyle modifications,” Dr Shafi said.

How asthma affects the eyes

Asthma not only affects the respiratory system, but can also impact the eyes.

Corticosteroid medications used to treat asthma can have side effects such as increasing the risk of cataracts and glaucoma.

“Studies have shown that individuals with asthma may be more likely to experience certain eye conditions, including glaucoma, cataracts, and allergic conjunctivitis. One possible reason for this association is the use of corticosteroid medications to treat asthma. These medications, which are often used to reduce inflammation in the airways, can also have side effects when used over long periods of time. Specifically, they can increase the risk of developing cataracts and glaucoma, both of which can lead to vision loss if left untreated,” Dr. Ajay Sharma, Chief Medical Director of Eye-Q, a chain of eye hospitals in India, told ABP Live.

Asthma also increases the likelihood of eye problems such as allergic conjunctivitis upon exposure to allergens such as pollen, dust or pet dander.

Asthmatics have chronic inflammation in their airways, and can also suffer from inflammation in other body parts, including the eyes.

“Inflammation in the eye can lead to a variety of conditions, including dry eye syndrome, uveitis, and scleritis,” Dr Sharma said.

Therefore, asthmatics must abide by the advice of their healthcare providers to manage their symptoms and monitor potential complications in the entire body.

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Comorbidities that aggravate asthma

Comorbidities or pre-existing medical conditions can aggravate asthma by worsening symptoms, increasing the risk of exacerbations, and making the disease more difficult to control.

“Some of the most common comorbidities that can aggravate asthma include allergic rhinitis, obesity, obstructive sleep apnea, chronic obstructive pulmonary disease, and anxiety and depression, among others,” Dr Shafi said.

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Allergic rhinitis

Allergic rhinitis, also known as hay fever, is a disease characterised by symptoms of nasal congestion, sneezing, itchy, water eyes and sore throat.

“Allergic rhinitis can cause nasal congestion, sneezing, and itchy eyes, and can worsen asthma symptoms by triggering inflammation in the airways,” Dr Shafi said.

Gastro esophageal reflux disease

Gastro esophageal reflux disease is a condition that develops when there is a backward flow of stomach contents back into the oesophagus, according to the United States’ National Institutes of Health (NIH). It results in heartburn and other symptoms, and can worsen asthma symptoms by causing irritation and inflammation in the airways, Dr Shafi said.


Obesity can worsen asthma symptoms by increasing inflammation and reducing lung function, according to Dr Shafi.

Obstructive sleep apnea

Obstructive sleep apnea is characterised by episodes of a complete (apnea) or partial collapse (hypopnea) of the upper airway, and is associated with a decrease in oxygen levels in the body, excessive daytime sleepiness abrupt awakenings due to gasping or choking, and morning headaches, according to Mayo Clinic. “This can worsen asthma symptoms by causing inflammation and constriction in the airways,” Dr Shafi explained.

Chronic obstructive pulmonary disease 

Chronic obstructive pulmonary disease (COPD) is a group of diseases that block airflow in the lungs and cause breathing-related problems, frequent coughing and wheezing. “COPD can worsen asthma symptoms by reducing lung function and causing chronic inflammation in the airways,” Dr Shafi said.

Anxiety and depression

Asthmatics often suffer from anxiety and depression. These can worsen asthma symptoms by causing hyperventilation or rapid and deep breathing, panic attacks and poor adherence to treatment, Dr Shafi explained.

He concluded that managing these comorbidities is an important part of controlling asthma and reducing the risk of exacerbations.

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