Transcript Chronic Diseases

November 18, 2010
7
out of 10 deaths among Americans each
year are from chronic diseases.
 Heart
disease, cancer and stroke account for
more than 50% of all deaths each year.
 In
2005, 133 million Americans – almost 1 out
of every 2 adults – had at least one chronic
illness.

Four Common Causes of Chronic Disease
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Smoking
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Physical Activity
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More than one-third of all adults do not meet
recommendations for aerobic physical activity
Nutrition
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43 million Americans smoke
In 2007, less than 22% of high school students9 and only
24% of adults reported eating 5 or more servings of fruits
and vegetables per day.
Alcohol

alcohol is a risk factor for primary liver cancer, and more
than 100 studies have found an increased risk of breast
cancer with increasing alcohol intake. The link between
alcohol consumption and colorectal (colon) cancer has
been reported in more than 50 studies
 Cardiovascular
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
Disease (CVD)
Cardiovascular disease is the cause of 37 percent of all
deaths in the United States.
For all ages combined, CVD is the leading cause of death.
More than 80 million Americans—1 out of every 3 adults—
will have some type of CVD.
The best defense against CVD is to prevent it from
developing in the first place.
 Do
you know someone who has had a heart
problem?
 The
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Four chambers
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Heart: A Mighty Machine
Two upper chambers are called atria
Two lower chambers are called ventricles
Valves regulate the flow of blood.
 Heart
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Function
Deoxygenated blood enters the right atrium
From the right atrium, blood travels to the right ventricle
Blood is pumped through the pulmonary artery to the
lungs, where it receives oxygen
Oxygenated blood from the lungs returns to the left
atrium of heart
Blood from the left atrium moves into the left ventricle
The left ventricle pumps blood through the aorta to all
body parts
 Atherosclerosis
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Arteriosclerosis
Hyperlipidemia
Inflammatory risk
Peripheral artery disease (PAD)
 Coronary
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(CAD— coronary artery disease)
Heart Disease (CHD)
Greatest killer
Myocardial infarction (MI) or heart attack
 Angina
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Pectoris
Ischemia—condition that reduces the heart’s blood and
oxygen supply
People with ischemia often suffer angina pectoris, or
chest pain and pressure.
Treatments include calcium channel blockers or betablockers
 Arrhythmias
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Irregularity in heart rhythm
Fibrillation
Over 4 million Americans have experienced some type of
arrhythmia
 Congestive
Heart Failure (CHF)
Affects over 5 million Americans
 Single most frequent cause of hospitalization in United
States

 Stroke
6.5 million Americans suffer strokes every year
 Blood supply to brain is interrupted
 Transient ischemic attacks (TIAs) are brief interruptions
of the blood supply to the brain that cause temporary
impairment.
 Today, stroke is a leading cause of serious long-term
disability and contributes a significant amount to
Medicaid and Medicare expenses for older Americans,
particularly women.
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 Metabolic
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Syndrome: Quick Risk Profile
For a diagnosis of metabolic syndrome, a person would
have three or more of the following risks:
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Abdominal obesity
Elevated blood fat (triglycerides greater than 150 units)
Low levels of HDL (“good”) cholesterol
Elevated blood pressure greater than 130/85 mm/Hg
Elevated fasting glucose greater than 100 mg/dL
High levels of C-reactive proteins
 Modifiable
Risks
Avoid tobacco.
 Cut back on saturated fats and cholesterol.
 Low-density lipoproteins (LDL)
 High-density lipoproteins (HDL)
 Triglycerides
 Maintain a healthy weight.
 Exercise regularly.
 Control diabetes.
 Control blood pressure.
 Manage stress.
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 Non-modifiable
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Race and ethnicity
Heredity
Age
Gender
 Other
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Risks
Risk Factors Being Studied
Inflammation and C-reactive protein
Homocysteine
 Bypass
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Surgery and Angioplasty
Coronary bypass surgery helps patients who suffer from
coronary blockages of heart attacks.
In bypass surgery, a blood vessel is taken from another site
in the patient’s body and implanted to “bypass” blocked
coronary arteries.
Angioplasty uses a balloon to open the artery to allow
blood to flow more freely.
Angioplasty carries fewer risks and may be more effective
in selected cases than bypass surgery.
 Can
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
Aspirin Help Heart Disease?
Low doses of aspirin (75 to 81 mg) daily or every other day
can be beneficial to heart patients
Blood-thinning properties
Risks may outweigh the benefits
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Second leading cause of death in the United States
1.5 million new cases diagnosed every year
Early detection and improvements in technology have
improved prognosis for many.
 Why
do you think the rate of cancer is so high in
the U.S. today?
 What
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Is Cancer?
Uncontrolled growth and spread of abnormal cells
Neoplasms
Malignant tumors
Benign tumors
 Lifestyle
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Risks
Tobacco use
Poor nutrition, physical inactivity, and obesity
Stress and psychosocial risks
Genetic and Physiological Risks
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Genetic predisposition
Oncogenes—cancer-causing gene that typically stays
dormant but can be activated
Biological sex
Reproductive and hormonal risks
 Occupational
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Exposure to asbestos, nickel, chromate, and benzene
Exposure to radioactive substances
Chemicals in foods
Medical treatment risks
 Infectious
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and Environmental Risks
Diseases and Cancer
Hepatitis B and hepatitis C
Liver cancer
Human papillomavirus and cervical cancer
 Categories
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Carcinomas
Sarcomas
Lymphomas
Leukemias
 Lung
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of Cancer
Cancer
Cause of death of 159,390 Americans in 2009
Symptoms include a persistent cough, blood-streaked
sputum, chest pain, and recurrent attacks of pneumonia
or bronchitis
Hazards of secondhand smoke
 Breast
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Cancer
Approximately 192,370 women and 1,910 men were
diagnosed in 2009
Risk increases with age
Risk factors supported by research
Prevention (self-exam and mammography)**
Treatment
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Surgical
Selective estrogen-receptor modulators (SERMs)
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Colon and Rectal Cancer
 Third most common cancer in men and women
 146,970 cases were diagnosed in 2009
 Warning signals include blood in the stool and rectal
bleeding.
Skin Cancer
 Affects over 1 million people every year
 Treatable: basal or squamous
 Virulent: malignant melanoma
 ABCD rule about melanoma
 Asymmetry
 Border irregularity
 Color
 Diameter
 Prostate
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Most frequently diagnosed cancer in American males
today, excluding skin cancer, and is the second leading
cause of cancer deaths in men after lung cancer
192,280 new cases were diagnosed in 2009.
Estimated 1 in 33 men will die from prostate cancer in
his lifetime
 Ovarian
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Cancer
Cancer
Fifth leading cause of death in women
21,550 new cases were diagnosed in 2009.
Enlargement of the abdomen is a common warning sign
Prevention: annual pelvic exams
 Cervical
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and Endometrial (Uterine) Cancer
Regular Pap tests are crucial for early detection
Risk: early onset of intercourse
Warning: abnormal bleeding
 Testicular
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Cancer
Ages 15 to 35 are at the greatest risk
Cause is unknown
Men with undescended testicles appear to be at the
greatest risk
 Detecting
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
Cancer
The earlier the cancer is diagnosed, the better prospect
there is for survival
Practice self-exam and checkups
Several high-tech tools have been developed to help
detect cancer
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Magnetic Resonance Imaging (MRI)
Computerized axial tomography scanning (CT scan)
 Breast
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Cancer
Women should know how their breasts normally
look and feel and report any breast change
promptly to their health care provider.
 Colorectal
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Colonoscopy starting at age 50
Stool sample testing
 Cervical
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Cancer
Cancer
All women should begin cervical cancer screening
about 3 years after they begin having vaginal
intercourse
Age 30 & Age 70
 Prostate
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Cancer
Age 45 & 50
PSA test
 Testicular
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TSE
Cancer
 Slash,
burn, & poison
 Cancer Treatments
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Surgery to remove tumor
Chemotherapy
Radiotherapy
Researching genes and cell mutations
Immunotherapy
Cancer-fighting vaccines
Stem cell research
 Diabetes
currently affects 23.6 million
Americans.
 Since 1980, incidence has increased over 50
percent among U.S adults.
 Diabetes is up by almost 70 percent among
those in their thirties.
 7.8 percent of the population has some form of
diabetes.
 Approximately 225,000 people die each year
from diabetes-related complications.
 It is the sixth leading cause of death in the
United States today.
 Diabetes
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Mellitus
Disease characterized by a persistently high
level of sugar (glucose) in the blood
Pancreas fails to produce enough insulin or the
body fails to use insulin effectively
Hyperglycemia—high blood glucose levels seen
in diabetes
 In
Healthy People, Glucose Is Taken Up
Efficiently by Body Cells
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Carbohydrates from the foods are broken down into
a monosaccharide called glucose.
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Liver and muscle cells store glucose as glycogen,
then use it as needed to fuel metabolism,
movement, and other activities
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Pancreas—an organ located just beneath the
stomach that secretes a hormone called insulin
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Insulin—hormone secreted by the pancreas and
required by body cells for the uptake and storage of
glucose
 Types
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of Diabetes
Type 1 diabetes
Type 2 diabetes
Gestational diabetes
 Pre-Diabetes
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Can Lead to Type 2 Diabetes
A condition in which blood glucose levels are
higher than normal, but not high enough to be
classified as diabetes
Affects more than 25 percent of the adult
population
A ticking time bomb; if it’s not “defused,”
diabetes will eventually strike
 Diabetes
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Care Can Be Expensive
On average, health care costs for diabetics are
$15,000 to $25,000 higher per year than for
healthy patients.
The direct and indirect costs of treating
diabetes in the United States total $174 billion
per year.
The costs related to undiagnosed diabetes are
unknown.
 The
pursuit of influencing outcomes
including: Public policy and resource
allocation decisions within political,
economic, and social systems and institutions
that directly affect peoples lives
 Major responsibility of health educators
 Tool for social/political change