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St. Louis Named Top Asthma Capital for 2009

Study Unveils Top 100 Most Challenging Places to Live with Asthma

WASHINGTON, Jan. 28 /PRNewswire/ -- St. Louis, MO, is ranked as the No.1 Asthma Capital - the most challenging place to live with asthma in the U.S. (1) - according to the Asthma and Allergy Foundation of America (AAFA), which conducted the study. This ranking was determined based on an analysis and scoring of 12 factors in the 100 largest U.S. metro areas. (1) St. Louis was ranked No.1 this year in part due to worse than average scores in crude death rate due to asthma (2.2%), higher than average pollen counts over the previous year and the lack of "100-percent" public smoke-free laws, which many other large cities are enacting. (1)

St. Louis topped the study after being ninth last year (2) due to a variety of factors, including poor air quality and a rise in the percentage of uninsured residents (2). It is interesting to note, however, that the prevalence of asthma, both estimated and self-reported in this city decreased slightly over the last year. (1,2)

In 2008, Knoxville, TN, ranked No.1 (2) but moved to the number seven spot in 2009 (1) because both the estimated and self-reported prevalence of asthma decreased, and reported pollen levels were lower than the national average, among other factors. (1) Of note, all of the top 10 Capitals scored "below average" with regard to whether these cities embraced "100-percent" public smoke-free laws. (1) The complete rankings with detailed data for each city can be found at

For six years, AAFA has scientifically researched and evaluated conditions in the largest metropolitan areas in America and ranked them based on quality of life for people with asthma in each city. The Foundation reviews 12 factors: Crude death rate (CDR) for asthma; the estimated prevalence of adult and pediatric asthma; risk factors, such as air pollution, pollen counts and public smoking bans; and medical factors, such as the number of asthma medications used per patient and the number of asthma specialists in the area. (1)

"For the last several years, I have seen an increase in the severity of asthma in our patients and how their life is affected by it," (1,2) said Mario Castro, MD, MPH, Professor of Medicine and Pediatrics, Washington University in St. Louis. "The lack of a smoke-free public environment for our patients with respiratory problems, especially asthma, (1) in St. Louis is appalling. Our return to the No. 1 Asthma Capital ranking is very concerning news for St. Louis asthma patients and physicians."(1) Asthma, if left uncontrolled, can result in serious consequences. (3) In fact, sudden asthma episodes account for an estimated 1.8 million emergency room visits (3) and nearly 500,000 hospital admissions (3) each year in the United States.

AstraZeneca sponsored this research to better understand the environmental factors and health policies that impact people with asthma, specifically around asthma control. For the last 20 years, AstraZeneca has helped millions of people manage their respiratory conditions through discovery and development of asthma treatments.

"Although St. Louis was found to be a particularly difficult place for people with asthma to live, asthma triggers are present in every American city," says Mike Tringale, AAFA's Director of External Affairs. "There is no way for asthma patients to escape their disease, (4) but no matter where they live, patients can work with their physicians to find ways to effectively control their symptoms and live a good quality of life." (5)

"We hope this survey ranking encourages asthma patients everywhere to talk to their doctors about how to avoid asthma triggers and effective asthma control," said Dr. Castro. "While asthma may not be curable, (4) it can be kept under control by following an asthma action plan that may include a controller treatment, as prescribed by a physician." (6)

A full report of the rankings, which was sponsored by a grant from AstraZeneca, the makers of SYMBICORT(R) (budesonide/formoterol fumarate dihydrate), is available at

Top 2009 Asthma Capitals

The top 10 Asthma Capitals for 2009, considered to be the most challenging places to live with asthma, are:

1. St. Louis, MO

2. Milwaukee, WI

3. Birmingham, AL

4. Chattanooga, TN

5. Charlotte, NC

6. Memphis, TN

7. Knoxville, TN

8. McAllen, TX

9. Atlanta, GA

10. Little Rock, AR (1)

Find the full rankings and complete data for all 100 cities at

About Asthma

Asthma is a condition characterized by inflammation of airways in the lungs resulting in chronic wheezing, coughing and difficulty breathing (3). Asthma has a significant impact on both individual lives and society, (3) including:

  • More than 4,000 deaths annually (3)
  • More than 500,000 hospitalizations annually (3)
  • 12.8 million missed days of school in 2003, making asthma the leading cause of school absenteeism (3,4)
  • Over 10 million missed days of work for adults each year (3)
  • 1.8 million emergency room visits each year (3)
  • $18 billion in medical expenses and indirect costs each year (4)

About AAFA

The Asthma and Allergy Foundation of America (AAFA) is the leading national nonprofit organization fighting asthma and allergic diseases. AAFA provides free information, conducts educational programs, fights for patients' rights, and funds research to find better treatments and cures. Log on to for more information.

About AstraZeneca

AstraZeneca is a major international healthcare business engaged in the research, development, manufacturing and marketing of meaningful prescription medicines and supplier for healthcare services. AstraZeneca is one of the world's leading pharmaceutical companies with healthcare sales of $29.55 billion and is a leader in gastrointestinal, cardiovascular, neuroscience, respiratory, oncology and infectious disease medicines. In the United States, AstraZeneca is a $13.35 billion dollar healthcare business with 12,200 employees committed to improving people's lives. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the FTSE4Good Index.

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SYMBICORT is a combination therapy indicated for the long-term maintenance treatment of asthma in patients 12 years of age and older.(7). Symbicort is not indicated in patients whose asthma can be successfully managed by inhaled corticosteroids along with occasional use of inhaled short-acting b2-agonists. (7) Administered twice daily, (7) SYMBICORT is a combination of two proven asthma medications--budesonide, an inhaled corticosteroid (ICS), and formoterol, a rapid and long-acting beta(2)-agonist (LABA). (7) SYMBICORT does not replace fast-acting inhalers and should not be used to treat acute symptoms of asthma. (7)

Important Safety Information

Long acting beta(2)-adrenergic agonists may increase the risk of asthma-related death. Therefore, when treating patients with asthma, SYMBICORT should only be used for patients not adequately controlled on other asthma-controller medications (e.g., low-to-medium dose inhaled corticosteroids) or whose disease severity clearly warrants initiation of treatment with two maintenance therapies. Data from a large placebo-controlled U.S. study compared the safety of another long-acting beta(2)-adrenergic agonist (salmeterol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol. This finding with salmeterol may apply to formoterol (a long-acting beta(2)-adrenergic agonist), one of the active ingredients in SYMBICORT. (7)

SYMBICORT is not indicated for the relief of acute bronchospasm. (7)

SYMBICORT should not be initiated in patients during rapidly deteriorating or potentially life-threatening episodes of asthma. (7)

Particular care is needed for patients who are transferred from systemically active corticosteroids. Deaths due to adrenal insufficiency have occurred in asthmatic patients during and after transfer from systemic corticosteroids to less systemically available inhaled corticosteroids. (7)

Patients who are receiving SYMBICORT twice daily should not use additional formoterol or other long-acting inhaled beta(2)-agonists for any reason. (7)

Common adverse events reported in clinical trials, occurring in greater than or equal to 5 percent of patients, regardless of relationship to treatment, including nasopharyngitis, headache, upper respiratory tract infection, pharyngolaryngeal pain, sinusitis, and stomach discomfort. (7)

Please see full Prescribing Information and visit


1. 2009 Allergy Foundation of America Asthma Capitals study results. Available at Accessed on 1/22/09.

2. 2008 Allergy Foundation of America Asthma Capitals study results. Available at Accessed on 1/22/09.

3. Centers for Disease Control. "Asthma Prevalence, Health Care Use and Mortality, 2003-2005" Available at Accessed 1/22/09.

4. Asthma and Allergy Foundation of America. "Asthma Facts and Figures." Accessed 1/22/09.

5. Asthma and Allergy Foundation of America. "Asthma Overview Prevention." Accessed 1/22/09.

6. National Heart, Lung and Blood Institute. "How Is Asthma Treated and Controlled?" Accessed 1.22.09.

7. SYMBICORT Prescribing Information.

SOURCE Asthma and Allergy Foundation of America
Copyright©2009 PR Newswire.
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