GINA Classification of Asthma Severity

The Global Initiative for Asthma (GINA) works with health care professionals and public health officials around the world to reduce asthma prevalence, morbidity, and mortality. The gold standard in classifying severity of asthma is the GINA classification.

Symptoms/Day
Symptoms/Night
PEF or FEV1
PEF variability
STEP 1
Intermittent
< 1 time a week
Asymptomatic and normal PEF between attacks
</= 2 times a month >/= 80% < 20%
STEP 2
Mild Persistent
> 1 time a week but < 1 time a day
Attacks may affect activity
> 2 times a month >/= 80% 20-30%
STEP 3
Moderate Persistent
Daily
Attacks affect activity
> 1 time a week 60%-80% > 30%
STEP 4
Severe Persistent
Continuous
Limited physical activity
Frequent </= 60% > 30%

PEF, Peak Expiratory Flow; FEV1, Forced Expiratory Volume in the first second.

  • The presence of one of the features of severity is sufficient to place a patient in that category.
  • Patients at any level of severity-even intermittent asthma-can have severe attacks.

 
 
References:

  1. Masoli M, Fabian D, Holt S, Beasley R; Global Initiative for Asthma (GINA) Program. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004 May;59(5):469-78. [Medline]
  2. Bousquet J. Global initiative for asthma (GINA) and its objectives. Clin Exp Allergy. 2000 Jun;30 Suppl 1:2-5. [Medline]

Created: August 12, 2005

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