GERD may be suspected in patients who do not respond to asthma treatments, whose asthma attacks follow episodes of heartburn, or whose attacks are worse after eating or exercise. People with asthma associated with GERD may be at risk for long-term erosion of the esophagus. The presence of sinusitis, however, does not appear to increase the severity of asthma. Other respiratory diseases, sinusitis, and ear infections are also on the rise, suggesting that airborne or environmental factors may be at work that affect all of these conditions, including asthma. Asthma occurs before the age of 15 more often in males, but it may be more common in girls after puberty.
White women are at much greater risk of death than white men and the disparity is increasing.
Some encouraging news includes reports of a general leveling off of asthma deaths in America since 1989 and a decline in British asthma deaths over the past decade. In addition to the elderly, the people at highest risk for severe asthma and death are the urban poor. The U.S. death rate from asthma increased between 1977 and 1994 from 1.5 to 3.7 per 100,000 African Americans and 0.5 to 1.2 per 100,000 whites. African-Americans are three times as likely as whites to die of the disease. To confound matters, however, regardless of socioeconomic factors, asthma rates and hospitalizations are dramatically higher in New York Puerto Ricans than in Hispanic-Americans who live in Los Angeles or the Southwest, indicating that other factors are at involved.