1. AWARENESS ON NON COMMUNICABLE DISEASES 24-03-2017 24TH MARCH, 2017
Presenter:
Dr. Manase Frank
[MD: Univ. of Dar es Salaam TZ, MPMed: Univ. of Cape Town SA, MPH: Johns Hopkins Univ USA, Post Doc: Johns Hopkins Univ. USA]
CEO & Founder The Community Center for Preventive Medicine
BOX Kinyerezi Mwisho, Ilala; Dar es Salaam Tanzania

2. https://youtu.be/AoNDvaqMMWM
CONTENTS
OBJECTIVES
CONTENTS
LINK TO THE LECTURE NOTES DERIVED FROM

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OBJECTIVES
AWARE ON NON COMMUNICABLE DISEASES WITH A FOCUS ON:
HYPERTENSION
STROKE
HEART ATTACK
CANCERS OF:
PROSTATE, CERVICX AND BREAST
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What is Blood Pressure?
The force of blood against the wall of the arteries.
Systolic- as the heart beats
Diastolic - as the heart relaxes
Written as systolic over diastolic.
Normal Blood pressure is less than 130 mm Hg systolic and less than 85 mm Hg diastolic.
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High Blood Pressure
A consistent blood pressure of 140/90 mm Hg or higher is considered high blood pressure.
It increases chance for heart disease, kidney disease, and for having a stroke.
1 out of 4 Americans have High BP
Tanzania 4 out of 10 people have BP
Has no warning signs or symptoms.
High blood pressure increases your chance for getting heart disease and kidney disease or for having a stroke. It is especially dangerous because it has no warning signs or symptoms. It is estimated that one in every four Americans has high blood pressure. Once it develops it can last a lifetime.
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6. Why is High Blood Pressure Important?
Makes the Heart work too hard.
Makes the walls of arteries hard.
Increases risk for heart disease and stroke.
Can cause heart failure, kidney disease, and blindness.
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7. How Does It Effect the Body? The Brain
High blood pressure is the most important risk factor for stroke.
Can cause a break in a weakened blood vessel which then bleeds in the brain.
How does it effect the body? High blood pressure is the most important risk facto for stroke. This can happen with a break in a weakened blood vessel which bleeds in the brain. A stroke can also happen when a blood clot blocks one of the narrowed arteries in the brain.
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The Heart
High Blood Pressure is a major risk factor for heart attack.
Is the number one risk factor for Congestive Heart Failure.
High blood pressure is a major risk for heart attack. The arteries bring oxygen carrying blood to the heart muscle. If the heart cannot get oxygen, chest pain know as angina can occur. If the flow of blood is blocked a hart attack results. Hypertension is also the number one risk facto of congestive heart failure. Which is a condition in which the heart cannot pump enough blood to meet the body’s needs.
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The Kidneys
Kidneys act as filters to rid the body of wastes.
High blood pressure can narrow and thicken the blood vessels.
Waste builds up in the blood, can result in kidney damage.
Kidneys act as filters to rid the body of wastes. High blood pressure can narrow and thicken the blood vessels. This makes it hard on the kidneys which will filter less blood. This results in waste building up in the blood and may result in the kidneys failing all together. Dialysis or kidney transplant my be needed in this situation.
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The Eyes
Can eventually cause blood vessels to break and bleed in the eye.
Can result in blurred vision or even blindness.
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The Arteries
Causes arteries to harden.
This in turn causes the kidneys and heart to work harder.
Contributes to a number of problems.
As people get older arteries throughout the body harden especially those in the heart, brain, and kidneys. This in turn causes the kidneys and heart to work harder and can contribute to a number of problems.
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12. What causes High Blood Pressure?
Causes vary
Narrowing of the arteries
Greater than normal volume of blood
Heart beating faster or more forcefully than it should
Another medical problem
The exact cause is not known.
Any of these conditions will cause pressure against arterial walls.
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13. Who can develop High Blood Pressure?
Anyone, but it is more common in:
African Americans- get it earlier and more often then Caucasians.
As we get older. 60% of Americans over 60 have hypertension.
Overweight, family history
High normal bp: /85-89 mm Hg.
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Detection
Dr.’s will diagnose a person with 2 or more readings of 140/90mm Hg or higher taken on more than one occasion.
White-Coat Hypertension
Measured using a spygmomameter.
Doctors will diagnose a person with two or more readings of 140/90 or higher taken on several occasions. A reason that it has to be more than one occasion is the occurrence of “White Coat Hypertension.” Some people experience high blood pressure simply from the stress of being in the Doctor’s office. If your Doctor suspects this they may send you home with a heart monitor to get appropriate readings.
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16. Tips for Having your blood pressure taken.
Don’t drink coffee or smoke cigarettes for 30 minutes before.
Before test sit for five minutes with back supported and feet flat on the ground. Test your arm on a table even with your heart.
Wear short sleeves so your arm is exposed.
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17. Tips for having blood pressure taken.
Go to the bathroom before test. A full bladder can affect bp reading.
Get 2 readings and average the two of them.
Ask the Dr. or nurse to tell you the result in numbers.
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18. Categories of High Blood Pressure
Ages 18 Years and Older)
Blood Pressure Level (mm Hg)
Category Systolic Diastolic
Optimal** < 120 < 80
Normal < 130 < 85
High Normal 130–139 85–89
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19. Categories of High Blood Pressure
Stage –159 /90–99
Stage –179 /100–109
Stage /110
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20. Preventing Hypertension
Adopt a healthy lifestyle by:
Following a healthy eating pattern.
Maintaining a healthy weight.
Being Physically Active.
Limiting Alcohol.
Quitting Smoking.
The best treatment is prevention. Adopt a healthy life by: following a healthy eating pattern. Research as shown that following a healthy eating plan can both reduce the risk of developing high blood pressure and lowering an already elevated blood pressure. Maintain a healthy weight. Be physically active, limit alcohol and quit smoking
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DASH diet
Dietary Approaches to Stop Hypertension.
Was an 11 week trial.
Differences from the food pyramid:
an increase of 1 daily serving of veggies.
and increase of 1-2 servings of fruit.
inclusion of 4-5 servings of nuts,seeds, and beans.
DASH diet – for an overall eating plan. Stands for dietary approaches to stop hypertension. It is based on an 11 week clinical trial which tested the effectiveness of diet against hypertension. The study found that a diet emphasized fruits and vegetables, low-fat dairy food, low in saturated fats, total fat, and cholesterol. There was a second study performed call DASH Sodium where they found by reducing the sodium in the diet to 1500 mg the biggest blood pressure benefits were gained. The basic differences from the food guide pyramid are: an increase of one daily serving of vegetables, and an increase of 1-2 servings of fruit, inclusion of 4-5 servings of nuts,seeds, and beans. Also recommends increasing the intake of calcium, magnesium and potassium which have been found to reduce blood pressure.
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22. Tips for Reducing Sodium
Buy fresh, plain frozen or canned “no added salt” veggies.
Use fresh poultry, lean meat, and fish.
Use herbs, spices, and salt-free seasonings at the table and while cooking.
Choose convenience foods low in salt.
Rinse canned foods to reduce sodium.
Most Americans eat way to much salt in their diets. The current recommendation is to consume less than 2.4 grams of sodium a day. 2 grams of sodium is equal to 1 teaspoon of salt. All our bodies actually need is 500 mg or ¼ teaspoon. Americans consume on the average 4000 to 6000 mg of sodium a day. For a person with high blood pressure the doctor my recommend a 1500 mg sodium diet. These low sodium diets can keep blood pressure from rising and help medications work better.
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23. Maintain Healthy Weight
Blood pressure rises as weight rises.
Obesity is also a risk factor for heart disease.
Even a 10# weight loss can reduce blood pressure.
Being overweight is a risk for developing high blood pressure and other diseases.
Sodium Quiz
If you are watching your sodium intake, eating a can of soup at lunch is a good alternative to a hamburger and fries? (True or False) False – One can of soup can have as much as 1300 mg of sodium.
Frozen dinners are a good choice when you are trying to eat less sodium? False – They can have as much as 1500 mg in just one serving.
Herbs, spices, and salt-free seasoning blends are better for cooking and putting on the table. True
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Be Physically Active
Helps lower blood pressure and lose/ maintain weight.
30 minutes of moderate level activity on most days of week. Can even break it up into 10 minute sessions.
Use stairs instead of elevator, get off bus 2 stops early, Park your car at the far end of the lot and walk!
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25. Limit Alcohol Intake
Alcohol raises blood pressure and can harm liver, brain, and heart
What counts as a drink?
12 oz beer
5 oz of wine
1.5 oz of 80 proof whiskey
Alcohol Quiz:
People with high blood pressure don’t have to limit the amount of alcoholic beverages they drink. False – alcoholic beverages raise blood pressure.
Alcoholic drinks contain calories which is another good reason to cut back on them if you are trying to lose weight and control high blood pressure. True, 5 oz of wine = 100 calories.
A 12 ounce beer counts as one drink the same as 5 ounces of wine or 1.5 ounce of whiskey. True – They are all considered one drink. The beer is 150 calories, the others are 100 calories.
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Quit Smoking
Injures blood vessel walls
Speeds up process of hardening of the arteries.
Smoking injures blood vessel walls and speeds up the process of hardening of the arteries. So even though it doesn’t cuse high blood pressure it is a bad idea for anyone, especially those with high blood pressure. Once you quit, your risk of having a heart attack is reduced after one year.
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Other Treatment
If Lifestyle Modification is not working, blood pressure medication may be needed, there are several types:
Diuretics-work on the kidney to remove access water and fluid from body to lower bp.
Beta blockers-reduce impulses to the heart and blood vessels.
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Other Treatment
ACE inhibitors- cause blood vessels to relax and blood to flow freely.
Angiotensin antagonists- work the same as ACE inhibitors.
Calcium Channel Blockers- causes the blood vessel to relax and widen.
Alpha Blocker- blocks an impulse to the heart causing blood to flow more freely.
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Other Treatment
Alpha-beta blockers- work the same as beta blockers, also slow the heart down.
Nervous system inhibitors- slow nerve impulses to the heart.
Vasodilators- cause blood vessel to widen, allowing blood to flow more freely.
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Conclusion
Hypertension is a very controllable disease, with drastic consequences if left uncontrolled.
Some Material kwenye Yu Tube:
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