1. 12 PowerPoint ® Lecture Outlines prepared by Dr. Lana Zinger, QCC  CUNY Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Cardiovascular Disease, Diabetes, and Cancer: Reducing Your Risk

2. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Cardiovascular Disease in the United States: An Epidemiological Overview  Cardiovascular disease (CVD) 37% of all deaths in the U.S. For all ages combined, CVD is leading cause of death More than 147,000 Americans killed by CVD are under the age of 65 80 million Americans will have some type of CVD  Do you know someone who has had a heart problem?

3. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.1 Prevalence of Cardiovascular Diseases in Adults Ages 20 and Older by Age and Sex

4. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Understanding the Cardiovascular System  The heart Four chambers Two upper chambers are called atria Two lower chambers are called ventricles Valves regulate the flow of blood

5. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.2 Anatomy of the Heart

6. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Understanding the Cardiovascular System  Steps in function Deoxygenated blood enters right atrium Travels to right ventricle Through pulmonary artery to the lungs (receives oxygen) From lungs to left atrium of heart Forced into left ventricle From left ventricle through aorta to all body parts

7. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cardiovascular Disease  Atherosclerosis (CAD-coronary artery disease) Arteriosclerosis Hyperlipidemia Inflammatory risk Syndrome X (Metabolic Syndrome)  Coronary heart disease (CHD) Greatest killer Myocardial infarction (MI) or heart attack

8. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cardiovascular Disease  Angina pectoris Ischemia Treatments include calcium channel blockers or beta blockers  Arrhythmias Irregularity in heart rhythm Fibrillation Over 4 million Americans diagnosed

9. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cardiovascular Disease  Congestive heart failure (CHF) Over 5 million Americans Single most frequent cause of hospitalization in U.S.  Congenital and rheumatic heart disease 1 in 125 children (present at birth) Rheumatic heart disease caused by unresolved streptococcal infections of the throat Antibodies attack the heart

10. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. ABC News: Cardiovascular Disease  Discussion Questions How does inflammation account for nearly 85% of all heart attacks? What test measures inflammation and how expensive is it? Why have physicians been hesitant to order tests to measure inflammation? What dietary changes are recommended to lower inflammation? Play Video Play Video | Cardiovascular Disease

11. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cardiovascular Disease  Stroke Blood supply to brain is interrupted Thrombus (blood clot) Embolus (a clot floating in the bloodstream) Aneurysm (a weakening in blood vessel that causes bulge or burst) 6 million Americans suffer every year Transient ischemic attacks (TIAs) - brief interruption

12. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.3 Percentage Breakdown of Deaths from Cardiovascular Disease in the United States

13. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Cross section of a normal coronary artery versus a coronary artery narrowed by plaque

14. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Reducing Your Risk for Cardiovascular Disease  Risks you can control Avoid tobacco Cut back on saturated fats and cholesterol Low-density lipoproteins (LDL) High-density lipoproteins (HDL) Triglycerides Changing lifestyle vs. cholesterol lowering drugs Reduce saturated fats Maintain a healthy weight  What types of activities can you begin to change today to reduce your risk?

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16. Reducing Your Risk for Cardiovascular Disease  Risks you can control (continued) Modify dietary habits Exercise regularly – modest levels, low-intensity even beneficial Control diabetes Control your blood pressure Hypertension (High blood pressure – HBP) the “silent killer” Manage stress

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18. Reducing Your Risk for Cardiovascular Disease  Risks you cannot control Heredity Age Gender Race

19. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Women and Cardiovascular Disease  Risk factors Estrogen Diabetes Cholesterol High blood pressure Kidney disease High cholesterol Smoking  What has happened in research to change the thinking on CVD and women?

20. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Women and Cardiovascular Disease  Neglect of heart disease symptoms Gender bias by physicians Viewed as a male disease Women decline major procedures more often than men

21. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. New Weapons Against Heart Disease  Techniques for diagnosing heart disease Electrocardiogram (ECG) Angiography Positron emission tomography scan (PET scan) Single-photon emission computed tomography (SPECT) Radionuclide imaging Magnetic resonance imaging (MRI) Ultrafast computed tomography scan (CT) Digital subtraction angiography (DSA)

22. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. New Weapons Against Heart Disease  Bypass surgery versus angioplasty Bypass more invasive Bypass has longer recovery time Angioplasty uses a balloon to open artery Angioplasty may not last long

23. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. New Weapons Against Heart Disease  Aspirin for heart disease Low doses of aspirin (80 mg) daily Risks may outweigh the benefits  Cardiac rehabilitation Every year, nearly 1 million people survive Some find it difficult to afford Benefits of these programs far outweigh any risk

24. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Diabetes: Disabling, Deadly, and on the Rise  Facts Currently affects 21 Million Americans Since 1980, increased over 50% among U.S adults Pancreas fails to produce enough insulin or the body fails to use insulin effectively Hyperglycemia- elevated blood sugar levels  Types Type 1 diabetes Type 2 diabetes Gestational diabetes

25. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Understanding Risk Factors  Overweight  Inactivity  Genetics  African Americans, Hispanics and Native Americans highest rates of type 2 diabetes

26. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.4 Diabetes: What It Is and How It Develops

27. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Controlling Diabetes  Insulin-related drugs  Losing weight  Exercise  Low fat, low sodium, high fiber diet

28. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Preventing Complications  If untreated, diabetes can cause or increase severity of diseases Cardiovascular disease Eye disease and blindness Kidney disease Amputations Pregnancy complications Flu and pneumonia-related deaths

29. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. ABC News: Noninfectious Conditions  Discussion Questions What is the incidence of diabetes among Native Americans over the age of 40? How has the federal government contributed to the poor nutritional status of Native Americans? What percentage of Native Americans on reservations are unemployed? Does this have a relationship to the high rate of physical inactivity? In an area of 50 x 100 miles and with a population of 38,000, how many fitness centers are available to Native Americans on this reservation? Play Video Play Video | Noninfectious Conditions

30. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. An Overview of Cancer  Facts Second leading cause of death in the U.S. 1.5 million new cases diagnosed every year Early detection/improvements in technology have improved prognosis for many  Why do you think the rate of cancer is so high in the U.S. today?

31. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. An Overview of Cancer  What is Cancer? Uncontrolled growth and spread of abnormal cells Neoplasms Malignant tumors Benign tumors

32. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings.

33. What Causes Cancer?  Cellular change/mutation theories Spontaneous errors External agents Oncogenes  Risks for cancer-lifestyle Smoking among greatest Nutrition/exercise  Biological factors Genetic predisposition Reproductive and hormonal risks

34. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.5 Factors Believed to Contribute to Global Causes of Cancer

35. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. What Causes Cancer?  Occupational and environmental factors Asbestos, nickel, chromate, benzene Radioactive substances Chemicals in Foods  Social and psychological factors Stress Decrease negative emotions

36. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Infectious Diseases and Cancer  Viral factors Human Papillomavirus Hepatitis B, C  Medical factors Diethylstibestrol (DES) Estrogen Chemotherapy

37. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings.

38. Types of Cancer  Classifications of cancer Carcinomas Sarcomas Lymphomas Leukemia's  Lung cancer Killed 160,390 in 2007 Prevention-researchers theorize: 90% of all lung cancers could be avoided by not smoking

39. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.6 Tobacco Use and Lung Cancer Deaths in the United States, 1900-2003

40. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.7 Leading Sites of New Cancer Cases and Deaths, 2007 Estimates

41. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cancer  Breast cancer 178,480 women and 2,030 men diagnosed in 2007 Risk increases with age Risk factors supported by research Prevention (self-exam and mammography) See figure 13.3 for self-examination procedure Treatment

42. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.8 Breast Awareness and Self-Examination

43. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cancer  Colon and rectum cancer 3rd most common in men and women 153,760 in 2007 diagnosed Warning signals- blood in the stool, rectal bleeding  Skin cancer Over 1 million people every year Treatable: basal or squamous Virulent: malignant melanoma ABCD rule about melanoma

44. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Skin Cancers Figure 12.9

45. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cancer  Prostate cancer Most common cancer in males today 218,890 new cases will be diagnosed in 2007 Estimated 1 in 33 men will die  Ovarian cancer 5th leading cause of death in women Enlargement of abdomen common sign Prevention: annual pelvic exams

46. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cancer  Endometrial (uterine) cancer Pap test for early detection Risk: early onset of intercourse Warning: abnormal bleeding  Testicular cancer Ages 15-35 at greatest risk Cause is unknown Undescended testicles present a great risk

47. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.10 Testicular Self-Examination

48. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. ABC News: Cancer  Discussion Questions Discuss the difficulties that Lance Armstrong faced during and after his cancer treatment. Were there other things that Lance wanted to prove than simply the ability to win another Tour de France title? What do you think are the most effective ways to cut the risk of death due to testicular cancer? Play Video Play Video | Cancer

49. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Types of Cancer  Cancer of the pancreas “Silent” disease 37,710 cases in 2007 Only 5% survive Contributors: inflammation, diabetes, high-fat diet  Leukemia Cancer of blood-forming tissues Leads to the creation of immature white blood cells Symptoms: fatigue / paleness / weight loss Can be acute or chronic

50. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Facing Cancer  Detecting cancer Magnetic Resonance Imaging (MRI) Computerized axial tomography scanning (CT scan) Prostatic ultrasound (rectal probe) Self-exam and check-ups

51. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Figure 12.11 CAUTION: Cancer’s Seven Warning Signals

52. Copyright © 2009 Pearson Education, Inc., publishing as Benjamin Cummings. Facing Cancer  New hope in cancer treatments Surgery to remove tumor Chemotherapy Radiotherapy Researching genes and cell mutations

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54. Facing Cancer  Life after cancer Laws reduce insurance discrimination Less isolation Assistance is available Support groups