Mild Persistent Asthma Classification: Diagnosis and Treatment

The Classification of Mild Persistent Asthma

South Africa, Cape Town, young jogger using asthma inhaler on the beach. Credit: Westend61 / Getty Images

If you've been told that you have mild persistent asthma, what does that mean and what is the definition? What is done to diagnosis this stage of asthma, and how is it treated? What can I expect in the long run, will it get better or get worse?

What is Mild Persistent Asthma? - Definition

Mild persistent asthma is one of the four types of asthma. People who suffer from mild persistent asthma generally have asthma symptoms more than twice a week, but not more than once a day (on average).

Their nighttime symptoms occur more than twice a month. Asthma attacks may affect the day-to-day activities of people with mild persistent asthma.

Asthma Classification: 4 Types

How asthma is classified is based on symptoms and the severity of the condition. To determine which category of asthma classification your condition falls into, your doctor will consider the following:

  • Symptoms such as difficulty breathing, wheezing, chest tightness, and coughing, all prior to treatment—Note that severe asthma attacks are possible in any asthma classification, even in the mildest classification of asthma.
  • How you perform on a lung function test or pulmonary function test (to determine the amount and speed of air you can blow)

Your asthma can change over time. It is important to note that asthma is difficult to diagnose and classify in children younger than the age of four, as symptoms can be different from the types of asthma exhibited in adults or older kids.

Categories of Asthma

Asthma has been classified into the following four categories by the National Asthma Education and Prevention Program. It's important to understand why your doctor may have describe your asthma as mild persistent asthma and understand the differences between these categories. Characteristics and timing of symptoms are described:

Intermittent Asthma. 

  • Symptoms occur two days or less per week and do not interfere with normal activities
  • Nighttime symptoms occur two days or less per month
  • When not having an asthma attack, lung function tests are normal and vary little from morning to afternoon.
  • Learn more about intermittent asthma

Mild Persistent Asthma. 

  • Occurrence of symptoms is more than two days per week but not every day. 
  • Asthma attacks interfere with normal daily activities. 
  • Nighttime symptoms occur three to four times a month.
  • Lung function tests are normal when not having an attack and may vary a small amount from morning to afternoon.

Moderate Persistent Asthma. 

  • A daily occurrence of symptoms and a short-acting inhaler is used every day. 
  • Symptoms interfere with daily activities. 
  • Nighttime symptoms occur more than one time a week, but do not happen every day and lung function tests are abnormal and vary more than 30 percent from morning to afternoon.

Severe Persistent Asthma. 

  • Symptoms occur throughout each day and severely limit daily physical activities. 
  • Nighttime symptoms occur often, sometimes every night. 
  • Lung function tests are abnormal and may vary greatly from morning to afternoon.

Diagnosis of Mild Persistent Asthma

According to the National Guidelines for managing asthma, your doctor will diagnose the severity of your asthma as mild persistent according to the following factors:

  • Frequency of symptoms (more than two days per week, but not daily)
  • Frequency of nighttime awakenings with asthma symptoms (three to four times per month)
  • Use of a quick-relief inhaler (more than two days per week, but not daily)
  • How much asthma interferes with daily activities (minor limitations)
  • Peak flow readings (at least 80 percent of your personal best)
  • Whether asthma flares require use or oral steroids (two or more times in a year)

Treating Mild Persistent Asthma

Once a diagnosis of asthma has been made, the doctor will prescribe asthma medications.

Mild persistent asthma is usually treated with two main types of asthma medications:

The two main types of asthma medicines are quick-relief medicines (used for immediate relief when an asthma attack begins) and long-term control medicines, which are to be taken every day to prevent symptoms and asthma attacks.

Prognosis of Mild Persistent Asthma

Over the years, the severity of asthma may fluctuate for many individuals, which means that medication and treatment may also fluctuate accordingly, with the ultimate goal being to keep asthma under control.

Bottom Line on Mild Persistent Asthma

Begin with learning about what everyone with asthma needs to know.

As noted above, mild persistent asthma interferes more with a person's life than intermittent asthma, but is not as severe as moderate or severe persistent asthma. In addition, anyone with any stage of asthma may develop a severe or life-threatening attack. If you are living with asthma of any type, make sure to have an asthma action plan in place. Though it is less likely with this classification than others such as severe persistent asthma, the possibility of a severe asthma attack is always present.

It's important to be your own advocate in your health, and learning about the requirements of different types of asthma, as well as advice on how to manage your asthma day to day is one such step in a very positive direction. Good medications are available for treating mild persistent asthma but this is just one step in caring for your health. Make sure you are familiar with the triggers for your asthma.

As a final note, make sure to learn about the 10 biggest mistakes that people with asthma make.

Sources:

Fanta, C., Treatment of intermittent and mild persistent asthma in adolescents and adults. UpToDate. Updated 03/18/16.

Kasper, Dennis L.., Anthony S. Fauci, and Stephen L.. Hauser. Harrison's principles of internal medicine. New York: Mc Graw Hill education, 2015. Print.

Makikyro, E., Jaakola, M., and J. Jaakola. Subtypes of Asthma Based on Asthma Control and Severity: A Latent Class Analysis. Respiratory Research. 2017. 18(1):24.

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