Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved. Chapter 11 - Chronic Diseases

Coming Up in this Chapter □Learn the major types of CVD, cancer, and diabetes. □Assess your personal risk factors for chronic disease. □Become familiar with screening, diagnosis, and treatment options. □Find out steps to reduce your risk factors. Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Table 11-1 Estimated prevalence and annual mortality from cardiovascular disease, cancer, and diabetes Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Cardiovascular Disease □One in three people die of CVD □These diseases are highly treatable □They are also highly preventable Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Circulation □The left side of the heart (systemic pump) receives the oxygenated blood from the lungs and pumps it to all the tissues in the body □The right side of the heart (pulmonary pump) receives deoxygenated blood from the body and pumps it to the lungs Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Circulation □Coronary arteries supply blood to the heart □Blood is so important to the heart that every muscle fiber is supplied by at least one capillary Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Conduction system □The heart has its own conduction system □The beating rate and rhythm are established by the sinoatrial (SA) node (pacemaker) □The electrical contraction pauses at the atrioventricular (AV) node, allowing the ventricles to fill with blood Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Cardiovascular Disease □Coronary artery disease □Stroke □Peripheral artery disease □High blood pressure □Heart failure □Heart murmurs Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Coronary artery disease □Usually cause by athero sclerosis □Can lead to arterio sclerosis □Diagnosed when any artery is narrowed by 60% or more Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Coronary artery disease □A myocardial infarction (heart attack; death of the heart muscle) □Angina pectoris □Arrhythmia Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Heart failure □The heart is unable to pump sufficient volume of blood □Shortness of breath □Fluid build up causing swelling □Fluid build up in lungs Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Stroke □Ischemic stroke □Hemorrhagic stroke □Transient Ischemic Attack (TIA) Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Stroke (Brain Attack) □Strokes are caused by a thrombus or an embolus (70% to 80%) or a cerebral hemorrhage □Brain cells die, causing loss of function of some parts of the body □Strokes have similar risk and prevention factors as heart disease Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

High Blood Pressure □Force of blood pumping against the vessel walls □Normal 120/80 □Systolic pressure (top number) □Diastolic pressure (bottom number) □Hypertension □High blood pressure Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

High Blood Pressure □Leads to weakening of the heart □Damages blood vessels □Risk factor in congestive heart failure □Risk factor in stroke □Risk factor in aortic aneurism Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Symptoms of Cardiovascular Disease □Some are painful and some are not □Shortness of breath □Swelling of the legs □Chest pain □Fatigue □Lightheadedness Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Fig 11-1 Percentage of breakdown of U.S. deaths from cardiovascular disease Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Assessing Risk □Heredity/Genetics □Age □Gender □Ethnicity Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Heredity □History of first degree male relatives, before the age of 55, who had CAD or MI □History of first degree female relatives, before the age of 65, who had CAD or MI Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Age Prevalence of CVD □Under 40 years less than 15% □Over 60 years over 70% Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Gender □Male: more likely to develop and die from CVD at a younger age □Female: more likely to die from a heart attack Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Cardiovascular Disease Prevention □Healthy diet □Physical activity □Weight control □Avoid tobacco □Avoid drugs □Moderate alcohol use Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Do you know your levels? Why not? □LDL should be less than 100 mg/dL □HDL should be more than 60 mg/dL □Total Cholesterol should be less than 200 mg/dL □ Triglycerides should be less than 150 mg/dL Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Cigarette Smoking/Tobacco Use □Cigarette smoking is considered to be the most harmful of the preventable risk factors □These illnesses include chronic bronchitis, emphysema, strokes, and 87% of all lung cancers □ Loss of life from smoking represents a life expectancy drop of ~18% Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Prevention □Regular screenings □Manage stress □Control blood pressure □Healthy cholesterol □Healthy triglycerides □Control diabetes Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Table 11-7 Tests for diagnosing and monitoring cardiovascular disease Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Treatment □Lifestyle change □Medications □Surgery □Coronary angioplasty □Coronary bypass □Pacemaker □Valve repair Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Diabetes □A metabolic disorder characterized by problems with the body’s production or use of insulin Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

How Diabetes Effects the Body Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Types of Diabetes □Type 1 diabetes □Autoimmune disease attacking and destroying the insulin producing cells of the pancreas □Type 2 diabetes □Cells don’t respond to insulin □Gestational diabetes □High glucose levels during pregnancy Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Type 1 Diabetes  An autoimmune disease that occurs most frequently in children and young adults □ In type 1 diabetes, the pancreas fails to produce any insulin □Insulin injections of daily monitoring of blood sugar levels are necessary Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Type II Diabetes The most common and is found primarily in people over 40 years old □Type 2 diabetes is strongly linked to heredity and obesity □Condition can often be controlled with diet, exercise, and weight management Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Type 2 Diabetes risk factors □Age □Excessive weight □Lack of physical activity □Family history □Gestational diabetes □Elevated blood sugar levels Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Do you know your blood sugar levels? Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Symptoms of Diabetes □Increased thirst □Increased hunger after eating □Dry mouth □Frequent urination □Weight loss or weight gain □Fatigue □Blurred or decreased vision □Slow healing sores or cuts Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Diabetes Prevention □Healthy diet □Physical activity □Healthy weight □Control cholesterol □Avoid tobacco Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Treatment □Use of insulin □Shots □Pumps □Lifestyle strategies □Oral medication Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Metabolic syndrome □Medical conditions that increase risk of both heart disease and diabetes □You have 3 of the following 5 traits 1.Large waist circumference 2.Elevated triglycerides 3.Low levels of HDL 4.Elevated Bp 5.Elevated blood glucose levels Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Cancer □Tumors are abnormal clumps of cells. □Benign means non-cancerous. □Malignant tumors are known as cancer. Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Fig 11-8 Stages and spread of cancer Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Types of Cancer □Carcinoma □Sarcoma □Lymphoma □Leukemia □Central nervous system cancers Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Assessing Your Risk □Heredity/Genetics □Age □Gender □Ethnicity □Exposure to cancer-causing agents Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Genetics □All cancers involve genetic mutation □Most are random □5-10% linked to inherited mutations Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Age □78% of all cancers are diagnosed in people over 55 □Testicular cancer more prevalent in young men ages □Common cancers for women in their twenties are thyroid, breast, cervix, uterus and Hodgkin lymphoma Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Carcinogens □Radiation: X-rays, radon, sunlight and tanning beds □Certain hormones and viruses □Asbestos □Tobacco □Solvents □pesticides Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Skin cancer □Most common cancer in the USA □Usually noninvasive and rarely fatal Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Types of skin cancer □Basal cell carcinoma □The most common skin cancer, but it grows slowly and rarely spreads □Squamous cell carcinoma □The second most common skin cancer; it also grows slowly, but it does metastasize □Malignant melanoma □The least common skin cancer, but it causes of 75% of skin cancer deaths Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Skin Cancer Knowing the ABCDs of skin cancer can help you detect melanoma in the early, treatable stages A = Asymmetry (halves are shaped differently) B = Border irregularity (may have scalloped or uneven edges) C = Color (color is not uniform) D = Diameter (larger than 6 mm) Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Signs and Symptoms - CAUTION □ C hange in bowel or bladder habits □ A sore that does not heal □ U nusual bleeding □ T hickening or lump in tissue □ I ndigestion or difficulty swallowing □ O bvious change in wart or mole □ N agging cough or hoarseness Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Prevention □Eat healthy. □Engage in regular physical activity. □Avoid smoking. □Practice safer sex. □Manage stress. □Avoid exposure. Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Treatment □Surgery □Removal of malignant tissue □Chemotherapy □Combination of drugs and hormones □Destroy cancer cells’ ability to divide and replicate; also affects health cells □Antiangiogenesis Therapy □Stops cancerous growths from developing new blood vessels □Only mild side effects □Not very effective as the sole treatment Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Diagnosis □Biopsy □Imaging procedures □Tumor marker or lab tests Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.

Chronic Disease Risk Reduction □Engage in regular physical activity. □Eat a balanced diet. □Don’t smoke. □Consume alcohol only in moderation. □Check your health history. Copyright © 2012 The McGraw-Hill Companies. All Rights Reserved.