Professional Documents
Culture Documents
LEARNING OBJECTIVES
Describe major & minor risk factors Enlist new emerging cardiovascular risk factors Describe prevention of cardiovascular diseases in relation to risk factors Describe prevention of HTN in according the level of prevention.
Lifestyles: tobacco use is increasing diets are rapidly changing physical activity reduces alcohol use increases obesity, diabetes, hypertension Demographic : population is ageing. Globalization : increasing global influences
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DISEASES, MATERNAL
AND PERINATAL CONDITIONS AND
32.5%
9.0%
Injuries (5.1 million)
NUTRITIONAL
DEFICIENCIES (18.4 MILLION)
45.9%
Noncommunicable conditions
COMMUNICABLE
42.0%
12.2%
DISEASES, MATERNAL
AND PERINATAL CONDITIONS AND
Injuries
NUTRITIONAL
DEFICIENCIES
Vilius GRABAUSKAS
The behavioural factors lead to high blood pressure & hypertension, blood glucose intolerance & diabetes, elevated blood cholesterol & hypercholesterol, anaemia, overweight and obesity.
Simple changes in these lifestyles can powerfully prevent chronic diseases and promote health. Some of the changes take place relatively quickly and also in late age.
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Vilius GRABAUSKAS
Chronic diseases are responsible for more than 24 million deaths a year, or almost half of the global total. The leading causes are circulatory diseases, including heart disease and stroke, cancer and chronic obstructive pulmonary disease. infectious diseases kill about 17 million people a year and afflict hundreds of millions of others, particularly in the developing world. In the industrialized world, infectious diseases are well under control. It is noninfectious diseases - particularly cancer, circulatory diseases, mental disorders including dementia, chronic respiratory conditions and musculoskeletal diseases - that now pose the greatest threat to health in developed countries. These are essentially the diseases that strike later in life and which, as life expectancy increases, will become more prevalent.
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As life expectancy in developing countries also increases, so the people will become more and more prone to diseases that are more common among older age groups. Outlook for most individuals in the developing world is that if they do manage to survive the killer infections of infancy, childhood and maturity, they will become exposed in later life to non communicable diseases. This situation is known as the "epidemiological transition" - the changing pattern of health in which poor countries inherit the problems of the rich, including not merely illness but also the harmful effects of tobacco, alcohol and drug use, and of accidents, suicide and violence. It is also referred to as the "double burden", because of the continuing weight of endemic infectious diseases.
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Industry
Change from agriculture to industry takes place over a few hundred years. Effect on health is profound, with the decline of infectious disease and the rise on non-communicable disease. Modern rise in population is distinguished from all previous increases by its size, continuity and duration. A major contributor is the decline in death rate -increase in normal longevity -- of modern man.
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Industry
Industrialists Risk factors: Sedentary lifestyle Longer life
Abundant food
Processed food Degraded environment Increase in medical technology
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"An impairment of structure or function that necessitates a modification of the patients normal life, and has persisted over an extended period of time".
Chronic diseases have one or more of the following characteristics. Are permanent. Leave residual disability. Are caused by non-reversible pathological alteration. Require special training for rehabilitation. Require long period of care and supervision.
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Cardiovascular,
Renal,
Nervous,
Mental,
Musculo-skeletal
(Arthritis), Chronic non-specific respiratory diseases (Chronic bronchitis, emphysema, asthma), Accidents, senility, blindness, Cancer, Diabetes, Obesity, Chronic results of communicable diseases.
Long Latent Period: This makes difficult to link suspected causes with
outcomes.
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Facts: Heart disease has no geographic, gender or socio-economic boundaries In1999 CVD contributed to a third of global deaths. In 1999, low and middle income countries contributed to 78% of CVD deaths. By 2010 CVD is estimated to be the leading cause of death in developing countries
CORONARY HEART DISEASE (IHD): "Impairment of heart function due to inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation to the heart".
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EPIDEMIOLOGY:
Epidemics USA Britain 1920 1930
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RISK FACTORS
Non Modifiable
Age
Modifiable
Cigarette smoking
Sex
Family History
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Newly emerging CVD risk factors in low and middle-income countries. Low birth weight Folate deficiency Certain infections Hypercoagulability Water hardness hypercalcemia
PREVENTION OF CHD:
Population strategy Primordial prevention Prevention in whole populations High Risk strategy Secondary prevention
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HYPERTENSION
(The level of blood pressure at which action is warranted)
"A systolic pressure equal to or greater than 140mm Hg or a diastolic pressure equal to or greater than 95mm Hg".
Classification:
Primary (Essential): when the causes are unknown is the most prevalent form accounting for 90% of all cases. Secondary: When some other disease process is involved in its causation (Kidney disease, tumors of adrenal gland, congenital narrowing of aorta, Toxemia's of pregnancy
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MORTALITY:
Major risk factor for stroke,CHD, Kidney failure.
Death rate per 100,000 population from hypertensive disease Country USA Japan Eng & wales France Total 14.4 11.6 10.4 9.9 Male 12.6 9.5 9.4 7.7 8.3 7 5 3.9 Female 16 13.6 11.3 12.1 10.1 9.6 7.2 5.7
Modifiable Obesity Salt intake Saturated fat Alcohol Physical inactivity Tension & stress Oral contraception Noise, vibration, temperature.
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PREVENTION OF HYPERTENSION:
1. Primary Prevention (Population Strategy): Nutrition: Salt intake less than 5 grams/day, Low fat, Avoidance of alcohal, energy intake according to body requirement. Weight Reduction Exercise Behavioral changes (reduction of stress, smoking) Health education & Self care High Risk Strategy (Tracking of blood pressure from
1 4 3 2 5 6 7 8 9
1. 2. 3. 4. 5. 6. 7.
Whole community Normotensive subjects Hypertensive subjects Un-Diagnosed Hypertension Diagnosed Hypertension Diagnosed but untreated Diagnosed & treated
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