1. Chronic Diseases

2. Objectives Define chronic disease.
List behaviors that increase the likelihood of getting a chronic disease.
Explain the relationship between chronic disease and medical care dollars.
Discuss preventive measures for chronic disease.
Describe the symptoms of cardiovascular disease, diabetes, and arthritis.
Discuss the treatments for various cancers.
Describe the diagnosis of cancers.

3. Chronic Versus Acute
An acute illness lasts for a few days and doesn’t have long-term effects. Examples are colds or the flu.
A chronic illness lasts a long time. Examples include cancer, diabetes, arthritis, and heart disease.

4. Economic Burden of Chronic Disease
Chronic diseases contribute 75% of the $2 trillion medical care costs in the United States.
Diabetes costs are $132 billion a year.
Medical care costs for arthritis are more than $22 billion.
Smoking costs are more than $75 billion.
Cardiovascular diseases cost $300 billion in 2001.
Costs related to physical inactivity were $76.6 billion in 2000.

5. Preventing Chronic Diseases
Many chronic diseases are referred to as lifestyle diseases.
Stopping smoking and improving diet and exercise habits can help prevent many chronic diseases.
Vaccines may prevent some chronic illnesses.
Spending more health care dollars on prevention could help.

6. Cardiovascular Disease
High blood pressure
Coronary artery disease (CAD)
Peripheral artery disease (PAD)
Cardiomyopathy
Aneurysm
(continued)

7. Cardiovascular Disease (continued)
Valvular heart disease
Pericardial disease
Heart failure
Arrhythmia
Stroke

8. Symptoms of Heart Disease
CAD: Chest pain from lack of oxygen to the heart
PAD: Pain in muscles, cramping in legs, cyanosis, poor nail growth
Pericardial disease: Chest pain from fluid buildup around the heart
Heart failure: Swollen feet, legs, and abdomen; chronic fatigue; confusion; difficulty breathing; coughing with sputum

9. Plaque Buildup in Artery

10. Myocardial Infarction (Heart Attack)

11. High Blood Pressure Normal blood pressure is less than 120/80 mmHg.
Prehypertension is 120/80 to 139/89 mmHg.
Stage 1 hypertension is 140/90 to 159/99 mmHg.
Stage 2 hypertension is 160/100 mmHg and above (Stein 2006).

12. Warning Signs of a Stroke
Sudden numbness or weakness in the face, arm, or leg (especially on one side of the body)
Sudden blurred or decreased vision in one or both eyes
Sudden inability to move part of the body (paralysis)
Sudden dizziness or headache with nausea and vomiting
(continued)

13. Warning Signs of a Stroke (continued)
Difficulty speaking or understanding words or simple sentences
Difficulty swallowing
Dizziness, loss of balance, or poor coordination
Brief loss of consciousness
Sudden confusion (WebMD 2006)

14. Controllable Risk Factors for Stroke
High blood pressure
Arterial fibrillation
Uncontrolled diabetes
High total cholesterol (more than 200 mg/dl)
Smoking
Alcohol (more than one drink per day)
Being overweight
Existing carotid or coronary artery disease

15. Arthritis Leading cause of disability in the United States
Types of arthritis
Osteoarthritis
Gout
Rheumatoid arthritis
Fibromyalgia
Systemic lupus erythematosus (SLE)

16. Signs and Symptoms of Arthritis
Osteoarthritis: Degeneration of cartilage and underlying bone, usually in hips, knees, hands, and spine
Gout: Acutely red, hot, and swollen joint with pain
Rheumatoid arthritis: Inflammation of joint lining that erodes cartilage and bone, usually in hands and feet
Fibromyalgia: Widespread muscular pain and fatigue
SLE: Fatigue, pain or swelling in joints, skin rashes, and fevers

17. Osteoarthritis

18. Gout

19. Lung Disease (COPD) Chronic bronchitis: 8.9 million diagnosed
Emphysema:
3.8 million diagnosed
Number of deaths: 13,913
Asthma:
15.7 million diagnosed
Number of deaths: 3,816
Lung cancer:
107,416 men and 89,271 women diagnosed
Number of deaths: 90,139 men and 69,078 women (CDC 2009)

20. Signs and Symptoms of COPD
Cough
Sputum (mucus) production
Shortness of breath, especially with exercise
Wheezing (whistling or squeaky sound while breathing)
Chest tightness

21. Chronic Bronchitis and Emphysema

22. Cancer Common types of cancer Treatment for cancers Lung cancer
Prostate cancer
Breast cancer
Treatment for cancers
Surgical removal of tumor
Chemotherapy
Radiation

23. Lung Cancer Diagnosed in over 170,000 Americans each year.
Symptoms include the following:
Shortness of breath
Wheezing
Chest pain
Coughing up blood
Can paralyze the vocal cords.
Invades the esophagus.
Overall 5-year survival rate is 16%.

24. Prostate Cancer Affects 70% to 90% of men over age 80.
Noncancerous disorders of prostate:
Benign prostatic hyperplasia
Prostatic intraepithelial neoplasia
Atypical small acinar proliferation
Surgical treatment for prostate cancer:
Preventive
Diagnostic
Curative

25. Rate of Survival for Prostate Cancer
Cancer that has not metastasized:
5-year rate is almost 100%.
10-year rate is 93%.
15-year rate is 77%.
Cancer that has metastasized: 5-year rate is 35%.

26. Breast Cancer Risk Factors
Being a woman
Having a mutation in the BRCA1 or BRCA2 breast cancer genes
Having a previous biopsy showing hyperplasia or carcinoma in situ
Having a family history of breast or ovarian cancer
Having high breast density on a mammogram
Having a personal history of breast or ovarian cancer
Having your first child after age 35
(continued)

27. Breast Cancer Risk Factors (continued)
Starting menopause after age 55
Never having children
Getting older
Being overweight after menopause or gaining weight as an adult
Having more than one drink of alcohol per day
Currently or recently using combined estrogen and progestin hormone replacement therapy (HRT)
Having your first menstrual period before age 12

28. Warning Signs of Breast Cancer
Change in look of one breast
Change in breast size or shape
Lump or thickening
Warm sensation
Nipple turned inward or appearing sunken
Irregularly shaped nipple
Rash on the nipple
Tenderness
Nipple discharge
Breast pain

29. Diagnosing Breast Cancer
Monthly self-exams
Clinical exam
Magnetic resonance imaging (MRI)
Digital mammography
Mammography

30. Breast Self-Exam

31. Breast Cancer Treatment
Surgery
Radiation
Chemotherapy
Hormone therapy
Targeted therapies

32. Diabetes Two types Risk factors
Type 1 is more common in young children; the body doesn’t produce insulin.
Type 2 is the most common type; results from insulin resistance.
Risk factors
Overweight
Lack of exercise
Poor diet
Diet high in carbohydrate and fat
Family history
Woman having a child > 9 lb (4 kg)

33. Signs and Symptoms of Diabetes
Always tired
Craving extra liquids
Frequent urination
Numbness and tingling in feet
Always hungry
Unexplained weight loss
Blurred vision
Sexual dysfunction

34. Diabetes Treatment Changing diet Exercising
Taking medicine to reduce glucose in the bloodstream

35. Alzheimer’s Disease Usually begins around age 60.
Symptoms include these:
Memory loss
Language deterioration
Poor judgment
Confusion
Restlessness
Mood swings