What’s the Difference Between Asthma and COPD?

By Sarah Malka, MD
Medically reviewed
September 27, 2021

Both asthma and chronic obstructive pulmonary disease (COPD) are long-term medical conditions that inflame the airways in your lungs and can make it difficult for you to breathe.

These conditions are common, affecting millions of people worldwide, and debilitating, even life-threatening in severe cases. 

Patients with asthma and COPD experience symptoms like shortness of breath, coughing or wheezing.

But despite sharing symptoms, asthma and COPD are different lung diseases. 

Patients with asthma have lungs that are sensitive to triggers and can become hyperresponsive when they are irritated.

During these episodes, called asthma attacks, the airways in the lungs become inflamed and narrow.

The muscles in the airways can spasm and tighten, and the lungs can begin to produce excess mucus, limiting how much air can move in and out of the body. 

When a patient has asthma, they may cough, wheeze, or experience chest pain or chest tightness due to their condition.

For most patients with asthma, symptoms are reversible with the appropriate medical treatment. 

Patients with COPD have airways that remain consistently inflamed, often because they have had long-term exposure to airborne irritants such as tobacco smoke.

As a result of this inflammation, people with COPD experience shortness of breath (particularly during physical activity), chest tightness, chronic cough, a lack of energy, and potentially swelling in the legs and arms.

Patients with COPD are also at a higher risk for developing chronic bronchitis, pneumonia, and other respiratory infections. 

COPD is a progressive lung disease that gets worse over time.

Though there are times when symptoms worsen or ease, they never reverse entirely.

Unlike people with asthma, people with COPD suffer from chronic lung inflammation that affects them daily.

In this article, I’ll describe more differences between asthma and COPD, including their symptoms, causes, and how each disease is treated.

I’ll also talk about how COPD and asthma are diagnosed, and how you can tell the difference. Finally, I’ll outline some ways you can prevent COPD and asthma, and when you should see a doctor.

Asthma vs. COPD

Asthma and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases that affect patient lung function and lead to difficulty breathing.

Although they both involve inflamed airways and can involve similar symptoms, it’s important to note that there are distinct differences between the two conditions and how each is treated.

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What is asthma?

Asthma is a chronic lung disease that inflames your airways and makes it difficult to breathe.

It is one of the most common respiratory conditions in America. It affects roughly 1 in every 13 Americans, including more than 5 million children, and 300 million people worldwide.

Some people are only impacted mildly or intermittently by the disease, while others have more severe asthma experiences.

When an asthmatic patient’s lungs are triggered by an allergen, exercise, smoke, or an illness, they can have an asthma attack—their small airways (bronchi) swell and narrow, the smooth muscle that surrounds their airways tighten, and their lungs begin to produce excess mucus, making it difficult to breathe.

Symptoms of asthma are generally reversible with short-acting inhalers or sometimes long-term control medications.

If you suspect you have asthma, speak with a healthcare provider about a treatment plan to help control your symptoms. Without effective treatment, asthma can be life-threatening.   

What is COPD?

COPD is a respiratory disease caused by lung damage associated with long-term exposure to cigarette smoke, secondhand smoke, fumes from burning fuel, and air polltion.

More than 16 million Americans have been diagnosed with COPD, and researchers suspect many more may be suffering without a diagnosis. 

COPD leads to chronically inflamed, narrow airways that produce too much mucus, making breathing difficult.

Patients with the condition often complain of shortness of breath, particularly with physical activity.

They also suffer from chronic coughing fits and regular respiratory tract infections. 

Although patients can manage symptoms with the right treatment plan, COPD is incurable, and gets worse over time.

According to the American Lung Association, it was the fourth leading cause of death after heart disease, cancer, and accidents in 2018.

Symptoms of Asthma vs. COPD

Because asthma and chronic obstructive pulmonary disorder (COPD) impact the respiratory system, there is significant overlap in their symptoms.

There are a few key differences between the two respiratory conditions, though, and patients must understand and identify which symptoms they experience so that a healthcare provider can make an accurate diagnosis. 

Asthma symptoms

Asthma patients have hyperreactive lungs that become inflamed when they come into contact with certain triggers, including allergens and pollution.

As asthma symptoms worsen, they develop into asthma attacks. Asthma often starts in childhood or infancy, but some develop it later in life.

Common symptoms that patients experience when they have asthma include: 

  • Shortness of breath or rapid breath
  • Chest pain or tightness
  • Coughing 
  • Wheezing
  • Difficulty sleeping or doing physical activity 

Asthma symptoms can range from mild to severe.

Without proper treatment, some cases can become life-threatening. If you are struggling or straining to breathe and feel weak, notice your face or lips turning blue, or have difficulty speaking, call 9-1-1 or seek medical attention right away.

COPD symptoms

Patients with COPD develop airway inflammation after being exposed to airborne irritants for a prolonged period.

COPD is a chronic disease that gets worse with time. Though COPD symptoms sometimes worsen during exacerbation periods, they never reverse the way that asthma symptoms do.

COPD almost always starts in adulthood, with the exception of some rare genetic conditions.

COPD symptoms include: 

  • Shortness of breath, mainly while doing physical activity
  • Wheezing
  • Chronic cough, particularly in the morning (smoker’s cough)
  • Fatigue
  • Excessive phlegm or mucus production
  • A bluish tinge to lips or fingernails 
  • Swelling in the ankles, legs, or feet
  • Recurrent respiratory infections, including chronic bronchitis and emphysema 

Some patients with COPD attribute their symptoms to old age or ill health, so they don’t seek medical attention until they are suffering from a late-stage version of the disease.

If you suspect you or someone you know has COPD, see a healthcare provider. An early diagnosis is the best way to manage the condition and improve quality of life.

Causes of Asthma vs. COPD

Although asthma and chronic obstructive pulmonary disease (COPD) share similar symptoms, they often develop for different reasons. 

Asthma causes

Although researchers still don’t know what causes asthma, different studies have demonstrated a few risk factors that make some patients more likely to develop the condition: 

  • A family history of asthma 
  • A medical history of allergies or respiratory illnesses, especially in early childhood
  • An occupation that exposes you to fumes, dust, vapors, or other environmental triggers
  • A home environment that exposes you to air pollution, secondhand smoke, or other irritants 

COPD causes

Patients develop COPD after experiencing long-term exposure to irritating airborne particulates.

These irritants damage lung tissue and lead to other structural changes in the lungs that make it more difficult to breathe. 

COPD tends to affect older adults with limited lung function who have a history of smoking, exposure to secondhand smoke, or lived in poorly ventilated homes that burn fuel for cooking and heating.

The three leading causes of COPD include: 

  • Smoking 
  • Environmental or occupational exposure to secondhand smoke, chemicals, dust, or toxic fumes 
  • A rare genetic disorder that leads to higher risk of lung damage by affecting the body’s ability to produce alpha-1, a protein that protects the lungs

Treatment of Asthma vs. COPD

If you have a hard time breathing or are suffering from other symptoms that you believe might be related to asthma or chronic obstructive pulmonary disorder (COPD), see a healthcare professional to discuss your condition.

They can evaluate your symptoms, make a diagnosis, and recommend a treatment plan that will help you manage your symptoms and lead a healthier life.

Asthma treatment

Several oral medications, inhalers, and other treatments are available to asthma patients.

Some are quick-acting, so patients can use them for fast relief when an asthma attack develops.

Others are long-term control medications that help keep asthma symptoms at bay. 

Common asthma treatments include:

  • Bronchodilators
  • Short-acting beta-agonists (SABAs)
  • Long-acting beta-agonists (LABAs)
  • Anticholinergics
  • Corticosteroids
  • Combination medications
  • Leukotriene modifiers
  • Theophylline
  • Cromolyn

Not all asthma medications are for everyone; your healthcare provider can help confirm your diagnosis and choose the appropriate treatment plan for you.

COPD treatment

Your doctor will ask you to do one or more medical tests before diagnosing you with COPD.

These tests may include:

  • Chest x-ray
  • Pulmonary function test
  • CT scan
  • Arterial blood gas analysis
  • Other lab tests to help them identify the disease 

Once they diagnose you, your doctor will recommend a combination of medications and lifestyle changes to help you manage your condition: 

  • Antibiotics 
  • Bronchodilators 
  • Bullectomy 
  • Lung transplant 
  • Lung volume reduction surgery
  • Oxygen therapy 
  • Phosphodiesterase-4 inhibitors
  • Steroids
  • Theophylline 
  • Ventilation therapy 

The most crucial step that any COPD patient can take to control their disease is to reduce exposure to smoke and other airborne irritants.

If you have a history of smoking, quitting is a great way to combat COPD’s effects and keep your lungs from deteriorating further.

Diagnosing Asthma vs. COPD

A healthcare professional can help you determine whether you have asthma, chronic obstructive pulmonary disorder (COPD), or something else.

They will listen to your symptoms, take note of your medical history, and may run a series of tests to evaluate your breathing and identify any issues.

Asthma diagnosis

In some cases, no specific tests are needed and your doctor may be able to make an asthma diagnosis based on your symptoms and a physical exam.

Your doctor may also run a series of tests to help them determine how well your lungs are functioning. These tests include: 

  • Fractional Exhaled Nitric Oxide (FeNO) test: This test measures the concentration of nitric oxide in the air you breathe out. This is an indication of how inflamed your lungs might be.
  • Peak flow meter test: This test measures the strength and speed of your exhalation, a marker of lung function.
  • Spirometry test: This test determines how well your lungs are working by measuring how much and how quickly you inhale and exhale.
  • Chest x-ray: This scan is used to see any visible damage to your lungs that might be causing breathing difficulties.
  • Allergy test: This test determines whether you have seasonal or food allergies, common triggers in people with asthma.

COPD diagnosis

If your doctor suspects you have COPD, they may order tests that can give them a better picture of whether or not you have the condition, how far along it has progressed, and whether or not you are suffering from anything else.

Those tests include: 

  • Chest x-ray: A scan to help doctors see any visible damage to the lung tissue.
  • Blood tests: A lab test that can identify whether you are suffering from anemia, polycythemia, or an alpha-1-antitrypsin deficiency, all conditions that often occur in people with COPD.
  • Blood oxygen level: A way to measure oxygen levels in your blood to see how well your lungs are functioning.
  • Peak-flow meter test: A test that measures how forcefully you exhale.
  • Spirometry test: A test that helps healthcare providers determine how well you are breathing in and out.

While they check your lung function, your provider may also order other tests to rule out heart disease or other health issues that often affect patients with COPD.

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How To Tell The Difference

Although asthma and chronic obstructive pulmonary disease (COPD) share similar characteristics, they are key differences.

Triggers

Every patient with asthma has different personal triggers that irritate their lungs, setting off their symptoms.

The most common include mold, dust, smoke, pollen, pet dander, pests, exercise, and respiratory infections.

Once triggered, asthma symptoms can remain mild or worsen into an asthma attack, but they are reversible once a patient treats them with medication or an inhaler.

Patients with COPD can experience exacerbated symptoms when around smoke, air pollution, fumes, cold or hot air, and airborne allergens. They can also develop respiratory infections.

When symptoms flare, medical treatments can help patients manage their condition, but unlike asthma, COPD symptoms are never completely reversible, even with appropriate treatment.

Age

Asthma can affect people of any age, including young children.

Some people develop asthma during childhood and experience the same symptoms into adulthood. Others may have severe asthma when they are younger, which evolves into a condition with fewer symptoms.

Still others can develop asthma without having experienced any symptoms as a young person. 

People develop COPD after they have inhaled irritants like cigarette smoke or air pollution for several years.

For that reason, seniors are at a higher risk for COPD than any other population. 

Comorbidities

Researchers are still studying why some medical conditions tend to be more prevalent in asthma patients than others.

Common associated conditions include obesity, sinus infections, runny nose, sleep apnea, and gastroesophageal reflux disease (GERD). 

There are also medical conditions that are more likely to affect patients with COPD, but they are different from those closely associated with asthma.

Conditions that commonly occur with COPD include heart disease, hypertension, diabetes, and osteoporosis.

Preventing Asthma and COPD

It may not be possible to prevent asthma completely, but there are steps you can take to reduce the risks of developing the disease: 

  • Quit smoking 
  • Avoid areas with heavy air pollution
  • Avoid occupations that can expose you to airborne irritants 
  • Prevent exposure to seasonal allergy triggers
  • Take steps to prevent respiratory infections, particularly for small children

The best way to prevent COPD is to avoid smoking tobacco products—or quit, if you have already developed the habit.

It is best to avoid exposure to secondhand smoke, air pollution, and other inhalable irritants.  

When To See A Healthcare Provider

Patients with asthma and COPD must receive appropriate medical care for their conditions.

If you are experiencing shortness of breath and believe you may have developed asthma or COPD, make an appointment to talk to your healthcare provider.

They’ll note your symptoms, evaluate your lungs, and recommend a treatment plan that can help you improve your quality of life.

If you are struggling or straining to breathe, have difficulty speaking, notice your face, lips, or tongue turning blue, or feel like you need to use your muscles for breathing, you may require immediate medical attention. Call 9-1-1 or go to your nearest emergency room right away.

How K Health Can Help

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Frequently Asked Questions

Is asthma or COPD more serious?
Both asthma and COPD are serious conditions that are manageable with treatment, but can be life-threatening in some cases. When patients with asthma experience asthma attacks, they can use medications and inhalers to reverse their symptoms. Patients who have COPD have more consistent symptoms that impact them every day. When their condition worsens, they may use medical treatments to help them breathe more easily, but COPD symptoms will never completely reverse.
Can asthma turn into COPD?
No, but you can suffer from both. Asthma and COPD are different diseases, but they can be caused by similar things, including exposure to pollutants, cigarette smoke, and airborne chemicals. A patient who has lung damage may experience one or both conditions within their lifetime.
Can COPD be misdiagnosed as asthma?
Sometimes COPD can be misdiagnosed as asthma or another breathing condition. If you suspect you have COPD, take note of your daily symptoms and report them to your healthcare provider. Include information like when and where you are most likely to cough, and when and where you experience shortness of breath and other symptoms. This can help your healthcare provider better understand your condition and give you the correct diagnosis.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.