Long-Term Effects of Asthma: Complications and Risks

Updated on March 18, 2025

Medically reviewed by Susan Russell, MD

The long-term effects of asthma can undermine your quality of life and ability to participate in everyday activities. If poorly controlled, asthma can cause structural changes to the lungs, leading to more frequent and severe asthma attacks and an increased risk of pneumonia, respiratory failure, and even death.

Although asthma may never be completely cured, keeping it well-controlled with medications and lifestyle changes can prevent long-term damage and preserve the good health of your lungs.

Long-Term Health Effects of Asthma — Jessica Olah / Verywell

Uncontrolled Asthma and Airway Remodeling

Uncontrolled asthma exposes the airways of the lungs (called the bronchi and bronchioles) to high levels of chronic inflammation. Over time, this can cause permanent changes to the lungs, known as airway remodeling, causing the lining of the bronchi and bronchioles to thicken and become less flexible.

These structural changes can lead to:

A progressive loss of lung function
Chronic coughing
Increased mucus production (mucus hypersecretion)
Increased sensitivity to asthma triggers like cigarette smoke, pollen, or cold temperatures

When this happens, a person may experience more frequent and violent asthma attacks. At the same time, medications used to treat asthma, such as inhaled bronchodilators and corticosteroids, may be less able to control attacks and more likely to cause side effects.

Severe airway remodeling can lead to an irreversible condition called bronchiectasis in which the airways become permanently widened.

Reduced Exercise Tolerance

With uncontrolled asthma, a person will almost invariably experience reduced exercise tolerance. This is when even mild to moderate levels of physical activity, like walking up stairs, can leave you breathless.

According to research published in the Journal of Clinical Medicine, people with severe asthma engage in considerably less physical activity than the average healthy adult—taking 31% fewer steps and engaging in 47.5% fewer minutes of physical activity per day.

Over time, a lack of activity can lead to an increased risk of metabolic and heart-related diseases like:

Increased Risk of Lung Infection

With uncontrolled asthma, a person is vulnerable to lung infections, including pneumonia. This is especially true in people who have experienced significant airway remodeling. In such cases, mucus can start to pool in the airways, creating a hotbed for bacterial growth.

In and of itself, asthma is associated with a threefold increased risk of pneumonia compared to the general population. When bronchiectasis is involved, the risk of pneumonia-related death is increased by 1.74-fold.

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Obstructive Sleep Apnea

People with asthma have a greater risk of developing obstructive sleep apnea (OSA), a condition that causes long gaps in breathing during sleep.

Studies have shown that uncontrolled asthma independently increases the risk of habitual snoring by twofold. Over time, this can lead to changes in the upper airways, causing them to sporadically "collapse" during sleep, leading to OSA.

On the flip side, OSA is linked to poor asthma control and more frequent asthma attacks during both the day and night. By controlling OSA with a continuous positive airway pressure (CPAP) machine, asthma symptoms tend to improve.

Gastroesophageal Reflux Disease

For reasons that are not entirely clear, acid reflux can worsen asthma symptoms and asthma can increase the risk of chronic acid reflux (commonly known as gastroesophageal reflux disease, or GERD).

In fact, studies suggest that nearly 80% of people with asthma have symptoms of GERD, while GERD is linked to a 1.15-fold increased risk of asthma.

Acid reflux may trigger asthma symptoms when the sudden onset of inflammation in the esophagus (feeding tube) "spills over" to smooth muscles of the airways. It is also possible that regurgitated acid might cause microaspiration (in which tiny amounts of stomach acid are breathed into the lungs).

Pregnancy Complications

According to the American College of Allergy, Asthma, and Immunology (ACAAI), asthma affects anywhere from 4% to 12% of females in their childbearing years. Of these, 4% to 8% will experience pregnancy complications. This is especially true for those with severe asthma and/or who have a history of poor asthma control.

Pregnant people with severe asthma will typically experience a worsening of asthma symptoms during weeks 24 to 36 of gestation. Around 10% may even experience an attack during labor or delivery.

In severe cases, this has been known to contribute to preeclampsia (a potentially deadly rise in blood pressure), placental abruption, and even fetal or maternal death.

Respiratory Failure

Respiratory failure is a serious condition that occurs when the lungs can't get enough oxygen into the blood. People with asthma who experience significant airway remodeling are at risk, especially those with bronchiectasis.

In severe cases, this can lead to an extreme type of asthma attack known as status asthmaticus. With status asthmaticus, a person will experience a severe drop in blood oxygen (hypoxemia) and an extreme increase in carbon dioxide (hypercapnia), leading to acute respiratory distress. In extreme cases, respiratory arrest (in which breathing stops entirely) can occur.

In 2021, 3,517 people died from asthma, many from asthma-induced respiratory failure.

How to Avoid Asthma Complications

Asthma is a potentially reversible condition when the right treatment is received at the right time. Management plays a critical role in all of this, helping prevent the progression of this obstructive lung disease.

To avoid long-term complications of poorly controlled asthma, speak with your healthcare provider to assess your current medications and lifestyle choices. Beyond changes in medications, you may benefit from lifestyle changes such as:

Identifying and avoiding asthma triggers.
Aiming for a healthy weight.
Choosing heart-healthy foods.
Getting regular physical activity.
Quitting smoking (or avoiding secondhand smoke).
Getting good quality sleep.
Monitoring your airflow to foresee asthma attacks and take preemptive action.

Summary

If asthma is poorly controlled, it can lead to long-term complications like airway remodeling, reduced exercise tolerance, an increased risk of lung infections, obstructive sleep apnea, GERD, and respiratory failure. It can also contribute to pregnancy complications like preeclampsia and pregnancy loss.

To avoid such complications, speak with your healthcare provider if asthma attacks are frequent or severe. Changes in medications and lifestyle may help reduce the frequency and severity of attacks, preventing long-term damage to the lungs.