NON COMMUNICABLE DISEASE PREVENTION AND CONTROL

INTRODUCTION

There are four major non-communicable diseases (also known as chronic diseases or lifestyle related diseases):
Cardiovascular

diseases

Cancer
Chronic

Obstructive Pulmonary Diseases (COPD) Diabetes Mellitus

PREVELANCE OF DISEASES

Cardiovascular diseases -19,594,621 Cancer - 395,982 COPD - 4,280,378 Diabetes Mellitus 5,073,040

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Risk Factors with Corresponding prevalence rates

Physical inactivity.......................60.5% Smoking.......................................34.8% Hypertension..............................22.5% Hypercholesteromia..................8.5% Obesity........................................4.9% Diabetes......................................4.6%

Diseases of the Heart and Blood Vessels (Cardiovascular Diseases) 1. Hypertention

Sustained elevation in mean arterial pressure Not a single disease state but a disorder with many causes, a variety if symptoms, and a range of responses to therapy Is a major risk factor for the development of other CVDs like coronary heart disease and stroke.

Hypertension
Etiology/Cause

Classified into primary and secondary hypertension Primary hypertension has no definite cause. Also called essential/idiopathic hypertension. About 90% of all hypertensives have primary hypertension. Although exact cause is unknown, primary hypertension is attributed to atherosclerosis Secondary hypertension usually the result of some other primary diseases leading to hypertension such as renal disease.

Hypertension

Risk Factors:

Family History
People

with a positive history of hypertension are twice at risk than those with no history. It is not known whether a single gene or multiple genes are involved

Hypertension

Age
Older

persons are at greater risk for hypertension than younger persons. The aging process that increases BP inlude stiffening of the arteries, decreased baroreceptor sensitivity, increased peripheral resistance and decreased renal flow.

Hypertension

High Salt Intake

Salt

intake does not cause hypertension in all people nor does reducing salt intake reduce BP in all hypertensives. Some people are more susceptible than others to effects of increased salt intake. How salt intake contributes to hypertension is still not clear. Salt may cause an elevation in blood volume, increase the sensitivity of cardiovascular or renal mechanisms to adrenergic influences, or exerts its effects through some other mechanisms such as the

Hypertension

Obesity
People

who are overweight/obese are at great risk of having hypertension and also people who are underweight. Mechanism of how obesity contributes to the development of hypertension is unknown. Weight loss is effective in reducing BP in obese hypertensive patients.

Hypertension

Excessive Alcohol Intake

10%

of hypertension cases could be related to alcohol consumption. Regular consumption of 3 or more drinks per day increases the risk for hypertension. Systolic pressures were more markedly affected than diastolic pressure

Hypertension

Key areas for Prevention of Hypertension

Encourage

Proper Nutrition Reduce salt and fat

intake Prevent becoming overweight or obese Weight reduction through proper nutrition and exercise. Smoking Cessation tobacco use promotes atherosclerosis that may contribute to hypertension; quitting smoking anytime is beneficial; this refers to active and passive smokers.

Hypertension

Key areas for Prevention of Hypertension

Identify

people with risk and encourage regular check-ups for possible hypertension and modification of risk factors.

Diseases of the Heart and Blood Vessels (Cardiovascular Diseases)

2. Coronary Artery

Disease

Caused by impaired coronary blood flow. Also called ischemic heart disease. When coronary arteries become narrow or clogged, supply of oxygen to the heart muscle is affected.

Coronary Artery Disease

When there is decreased oxygen supplied to the heart muscle, chest pain (called angina) occurs. CAD can cause myocardial infarction (heart attack), arrhythmias, heart failure, and sudden death.

Coronary Artery Disease

Etiology/Causes Atherosclerosis
the

thickening of the inside walls of arteries due to deposition of a fat like substance. This narrows the space through which blood can flow, decreasing and sometimes completely cutting off supply of oxygen and nutrients to the heart. Usually occurs when a persons has high levels of cholesterol in the blood.

Coronary Artery Disease

Risk factors:

Elevated blood cholesterol levels Hypertension Smoking Obesity Sedentary lifestyle Stress Heredity Increasing age

Coronary Artery Disease

Elevated blood cholesterol

High LDL also know as bad cholesterol is the main carrier of cholesterol and contributes to athersclerosis. LDL levels are increased by high saturated fat intake, obesity, sedentary lifestyle, smoking androgens and certain drugs.

Coronary Artery Disease

Smoking/Tobacco Use

Risk of death from CAD is 70-200 times greater for men who smoke one or more packs of cigarretes a day.

Coronary Artery Disease

Key areas for Prevention of CAD

Promote regular physical activity and exercise; exercise increases HDL, prevents obesity and improves optimum functioning of the heart. Encourage proper nutrition particularly by limiting intake of saturated fats that increase LDL, limiting salt intake and increasing intake of dietary fiber by eating more vegetables, fruits, unrefined cereals

Coronary Artery Disease

Advise smoking cessation for active smokers and prevent exposure to second hand smoke by family members, friends and co workers of active smokers. Early diagnosis, prompt treatment and control of diabetes and hypertension; these diseases are risk factors and contribute to the development of coronary artery disease.

Diseases of the Heart and Blood Vessels (Cardiovascular Diseases)

3. Cerebrovascular Disease or Stroke

Loss

or alteration of body function that results from an insufficient supply of blood to some parts of the brain. If blood is obstructed for more than several minutes, injury to brain cells becomes permanent resulting to cerebral infarction.

Cerebrovascular Disease or Stroke

Etiology/Causes Most common cause of stroke is atherosclerosis 3 typers of strokes
caused by advanced atherosclerosis Embolic Caused by a blood clot formation Hemorrhagic (most fatal) rupture of blood vessel in the brain
Thrombolic

Cerebrovascular Disease or Stroke

Risk factors

Increasing Age
The

chance of having a stroke more than doubles for each decade of life after age 55. While stroke is common among the elderly, many people under 65 also have strokes.

Cerebrovascular Disease or Stroke

Heredity (family history) and race

The

chance of stroke is greater in people who have a family history of stroke. African Americans have a much higher risk of disability and death from a stroke than Whites, in part because Blacks have a greater incidence of high blood pressure, a major risk factor.

Cerebrovascular Disease or Stroke

Hypertension
High

blood pressure is the most important risk factor for stroke. Stroke risk varies directly with blood pressure

Cerebrovascular Disease or Stroke

Cigarettes smoking
The

nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways.

Cerebrovascular Disease or Stroke

Diabetes Mellitus
Diabetes

is an independent risk factor for stroke and is strongly correlated to high blood pressure. While diabetes is treatable, having it increases a persons risk of stroke. People with diabetes often also have high cholesterol and are overweight, increasing their risk even more

Cerebrovascular Disease or Stroke

Heart Diseases
People

with heart problems have more than twice the risk of stroke as those whose hearts work normally. Atrial fibrillation (rapid uncoordinated beating of the hearts upper chambers) in particular, raises the risk for stroke. Heart attack is also the major cause of death among stroke survivors.

Cerebrovascular Disease or Stroke

High red blood cell count

A

moderate or marked increase in the red blood cell count is a risk factor for stroke. The reason is that more red blood cells thicken the blood and make clots more likely. This is present in persons with chronic heart and lung diseases.

Cerebrovascular Disease or Stroke

Season and climate

Stroke

deaths occur more often during periods if extremely hot or cold temperatures.

Cerebrovascular Disease or Stroke

Socioeconimic factors
There

is some evidence that people of lower income and educational levels have a higher risk for stroke.

Cerebrovascular Disease or Stroke

Excessive alcohol intake

Excessive

drinking (more than one drink per day for women and more than two drinks for men) and binge drinking can raise blood pressure, contribute to obesity, high triglycerides, cancer and other diseases, cause heart failure and lead to stroke.

Cerebrovascular Disease or Stroke

Certain kinds of drug abuse

IV

drugs abuse carries a high risk of stroke from cerebral emboli. Cocaine use has been closely related to strokes, heart attacks and a variety of other cardiovascular complications. Some of them have been fatal even in first time cocaine users.

Cerebrovascular Disease or Stroke

Key areas for Prevention of Stroke

Treatment and control of hypertension Many people believe that effective treatment of high blood pressure is a key reason for the rapid decline in the death rates for stroke. Smoking cessation and promoting a Smokefree environment. Prevent thrombus formation in rheumatic heart disease and arrythmias with appropriate medications.

Cerebrovascular Disease or Stroke

Limit alcohol consumption for women, not more than one drink per day, and for men, not more than two drinks per day. Avoid intravenous drug abuse and cocaine Prevent all other risk factors of atherosclerosis.