Your asthma can improve or worsen over time, so you may be given different classifications throughout the years if your disease changes. Following changes in your asthma severity can help guide the type and dose of medication you may need for managing your symptoms.
Mild Persistent Asthma Criteria
Asthma is classified based on several factors, including the frequency, severity, and impact of symptoms on daily activities.
Your healthcare provider will consider your medical history, perform a physical examination, and order diagnostic tests to determine if your asthma is mild persistent or not. The first time this is done, they will base the assessment on your asthma symptoms and test results without treatment.
Symptoms
Your asthma symptoms may include difficulty breathing, wheezing, chest tightness, and coughing, like all cases of asthma.
The criteria for mild persistent asthma criteria further define the presentation of symptoms for this type:
The effects of asthma pose minor limitations on normal activities. The occurrence of symptoms is more than two days per week but not every day. Nighttime symptoms occur three to four times a month. Symptoms require the use of a short-acting inhaler less than once per week.
Your healthcare provider will ask how often you experience the effects of the disease and the degree to which your asthma interferes with your everyday life.
Pulmonary Function Tests (PFTs)
Classifying your asthma also involves an assessment of your pulmonary function tests (PFTs). These tests require your cooperation as you breathe into a mouthpiece.
Diagnostic PFTs measure the volume of air your lungs can inhale and exhale over a given amount of time (such as a second). Your values are compared to standard values.
Key measures in asthma classification include forced expiratory volume in one second (FEV1), which is how much air you can expire after taking in a deep inhalation. Another key measure is the ratio of FEV1 to forced vital capacity (FCV)—which is reported as FEV1/FVC.
PFT criteria for a classification of mild persistent asthma include:
Forced expiratory volume in one second (FEV1) between 80% to 100% of normal values FEV1/FVC between 80% to 100% normal values
With asthma, PFT values are decreased. Mild persistent asthma causes a moderate decline in these values in comparison to normal values.
Your FEV1/FVC value is prioritized over FCV in terms of placing your asthma into the classification of mild persistent asthma, but your healthcare provider will use judgment when using these criteria as a diagnostic tool.
Other Characteristics of Your Diagnosis
In addition to classifying your asthma based on its severity, you will also be diagnosed with a specific type of asthma. There are several, and they are based on triggers.
You meet more of the symptom or testing criteria for this asthma classification than that of any of other individual asthma classification. Your overall measures average aligns most closely with mild persistent asthma.
For example, if you meet the above criteria and physical activity is what brings on your asthma symptoms, you likely have mild persistent exercise-induced asthma. If exposure to pollen exacerbates your condition, you likely have mild persistent allergic asthma.
On follow-up visits, your healthcare provider may also assess your asthma as well-controlled, not well controlled, or very poorly controlled based on criteria that include nighttime awakenings, rescue inhaler use, and lung function.
Asthma control is not the same as asthma classification, but it also helps guide your treatment, especially because it may be difficult for your healthcare provider to reassess your asthma without medication if you rely on it.
Treatment
Asthma treatment is tailored to asthma classification and asthma type. There are several asthma medications for your healthcare provider to consider, including oral pills, inhalers, and nebulizer treatments.
Asthma treatments used for mild persistent asthma include quick-relief rescue medicines (used for immediate treatment when an asthma attack begins) and long-term control medicines, which are taken every day to prevent symptoms and asthma attacks.
The idea behind taking long-term medications is to avoid having to experience asthma attacks that necessitate rescue medications or other urgent treatment.
When you have mild persistent asthma, your healthcare provider will likely prescribe first-line medications for you such as inhaled steroids and bronchodilators, and you might only need to use relatively low doses.
If your asthma fluctuates over time, your medication will need to be adjusted—the goal is always optimal disease control with minimal side effects.
Keep in mind that anyone who has asthma can experience a life-threatening asthma attack, even if the asthma is classified in one of the milder categories. Be sure that you are prepared for such an event.
Is Your Asthma Still Mild Persistent?
Intermittent asthma is the mildest form of asthma, with infrequent symptoms and no interference with normal activity. It is possible that, with proper trigger control and treatment, your mild persistent asthma could be downgraded to this classification.
On the other hand, while your disease can worsen due to circumstances that are out of your control, like genetics, factors like frequent exposure to asthma triggers or skipping your medications can worsen your asthma severity and push you into a more severe classification.
Moderate persistent asthma affects your daily activities and requires daily use of short-acting inhalers.
If you experience symptoms throughout the day, you may be diagnosed with severe persistent asthma.
The classifications are helpful for gauging changes in your disease. When re-evaluating you case, your healthcare provider will carefully evaluate your symptoms and diagnostic tests while taking into account the fact that your medication use colors how criteria can be considered.
A Word From Verywell
If you have been diagnosed with mild persistent asthma, make sure to have an asthma action plan in place. Medications can help keep mild persistent asthma under control, but this is just one step in caring for your health. Make sure you are familiar with your asthma triggers because avoiding an attack is better for your overall health than having a sudden attack (even if it is treated in time).
