1. November 18, 2010

2.  7 out of 10 deaths among Americans each year are from chronic diseases.  Heart disease, cancer and stroke account for more than 50% of all deaths each year.  In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness.

3.  Four Common Causes of Chronic Disease  Smoking 43 million Americans smoke  Physical Activity More than one-third of all adults do not meet recommendations for aerobic physical activity  Nutrition In 2007, less than 22% of high school students 9 and only 24% of adults reported eating 5 or more servings of fruits and vegetables per day. 9  Alcohol alcohol is a risk factor for primary liver cancer, and more than 100 studies have found an increased risk of breast cancer with increasing alcohol intake. The link between alcohol consumption and colorectal (colon) cancer has been reported in more than 50 studies

4.  Cardiovascular Disease (CVD)  Cardiovascular disease is the cause of 37 percent of all deaths in the United States.  For all ages combined, CVD is the leading cause of death.  More than 80 million Americans—1 out of every 3 adults— will have some type of CVD.  The best defense against CVD is to prevent it from developing in the first place.  Do you know someone who has had a heart problem?

6.  The Heart: A Mighty Machine  Four chambers Two upper chambers are called atria Two lower chambers are called ventricles  Valves regulate the flow of blood.

8.  Heart Function  Deoxygenated blood enters the right atrium  From the right atrium, blood travels to the right ventricle  Blood is pumped through the pulmonary artery to the lungs, where it receives oxygen  Oxygenated blood from the lungs returns to the left atrium of heart  Blood from the left atrium moves into the left ventricle  The left ventricle pumps blood through the aorta to all body parts

10.  Atherosclerosis (CAD— coronary artery disease)  Arteriosclerosis  Hyperlipidemia  Inflammatory risk  Peripheral artery disease (PAD)  Coronary Heart Disease (CHD)  Greatest killer  Myocardial infarction (MI) or heart attack

12.  Angina Pectoris  Ischemia—condition that reduces the heart’s blood and oxygen supply  People with ischemia often suffer angina pectoris, or chest pain and pressure.  Treatments include calcium channel blockers or beta- blockers  Arrhythmias  Irregularity in heart rhythm  Fibrillation  Over 4 million Americans have experienced some type of arrhythmia

13.  Congestive Heart Failure (CHF)  Affects over 5 million Americans  Single most frequent cause of hospitalization in United States  Stroke  6.5 million Americans suffer strokes every year  Blood supply to brain is interrupted  Transient ischemic attacks (TIAs) are brief interruptions of the blood supply to the brain that cause temporary impairment.  Today, stroke is a leading cause of serious long-term disability and contributes a significant amount to Medicaid and Medicare expenses for older Americans, particularly women.

14.  Metabolic Syndrome: Quick Risk Profile  For a diagnosis of metabolic syndrome, a person would have three or more of the following risks: Abdominal obesity Elevated blood fat (triglycerides greater than 150 units) Low levels of HDL (“good”) cholesterol Elevated blood pressure greater than 130/85 mm/Hg Elevated fasting glucose greater than 100 mg/dL High levels of C-reactive proteins

15.  Modifiable Risks  Avoid tobacco.  Cut back on saturated fats and cholesterol. Low-density lipoproteins (LDL) High-density lipoproteins (HDL) Triglycerides  Maintain a healthy weight.  Exercise regularly.  Control diabetes.  Control blood pressure.  Manage stress.

18.  Non-modifiable Risks  Race and ethnicity  Heredity  Age  Gender  Other Risk Factors Being Studied  Inflammation and C-reactive protein  Homocysteine

19.  Bypass Surgery and Angioplasty  Coronary bypass surgery helps patients who suffer from coronary blockages of heart attacks.  In bypass surgery, a blood vessel is taken from another site in the patient’s body and implanted to “bypass” blocked coronary arteries.  Angioplasty uses a balloon to open the artery to allow blood to flow more freely.  Angioplasty carries fewer risks and may be more effective in selected cases than bypass surgery.

20.  Can Aspirin Help Heart Disease?  Low doses of aspirin (75 to 81 mg) daily or every other day can be beneficial to heart patients  Blood-thinning properties  Risks may outweigh the benefits

21.  Second leading cause of death in the United States  1.5 million new cases diagnosed every year  Early detection and improvements in technology have improved prognosis for many.  Why do you think the rate of cancer is so high in the U.S. today?

22.  What Is Cancer?  Uncontrolled growth and spread of abnormal cells  Neoplasms  Malignant tumors  Benign tumors

24.  Lifestyle Risks  Tobacco use  Poor nutrition, physical inactivity, and obesity  Stress and psychosocial risks  Genetic and Physiological Risks  Genetic predisposition  Oncogenes—cancer-causing gene that typically stays dormant but can be activated  Biological sex  Reproductive and hormonal risks

26.  Occupational and Environmental Risks  Exposure to asbestos, nickel, chromate, and benzene  Exposure to radioactive substances  Chemicals in foods  Medical treatment risks  Infectious Diseases and Cancer  Hepatitis B and hepatitis C  Liver cancer  Human papillomavirus and cervical cancer

27.  Categories of Cancer  Carcinomas  Sarcomas  Lymphomas  Leukemias  Lung Cancer  Cause of death of 159,390 Americans in 2009  Symptoms include a persistent cough, blood-streaked sputum, chest pain, and recurrent attacks of pneumonia or bronchitis  Hazards of secondhand smoke

29.  Breast Cancer  Approximately 192,370 women and 1,910 men were diagnosed in 2009  Risk increases with age  Risk factors supported by research  Prevention (self-exam and mammography)**  Treatment Surgical Selective estrogen-receptor modulators (SERMs)

31.  Colon and Rectal Cancer  Third most common cancer in men and women  146,970 cases were diagnosed in 2009  Warning signals include blood in the stool and rectal bleeding.  Skin Cancer  Affects over 1 million people every year  Treatable: basal or squamous  Virulent: malignant melanoma  ABCD rule about melanoma Asymmetry Border irregularity Color Diameter

33.  Prostate Cancer  Most frequently diagnosed cancer in American males today, excluding skin cancer, and is the second leading cause of cancer deaths in men after lung cancer  192,280 new cases were diagnosed in 2009.  Estimated 1 in 33 men will die from prostate cancer in his lifetime  Ovarian Cancer  Fifth leading cause of death in women  21,550 new cases were diagnosed in 2009.  Enlargement of the abdomen is a common warning sign  Prevention: annual pelvic exams

34.  Cervical and Endometrial (Uterine) Cancer  Regular Pap tests are crucial for early detection  Risk: early onset of intercourse  Warning: abnormal bleeding  Testicular Cancer  Ages 15 to 35 are at the greatest risk  Cause is unknown  Men with undescended testicles appear to be at the greatest risk

35.  Detecting Cancer  The earlier the cancer is diagnosed, the better prospect there is for survival  Practice self-exam and checkups  Several high-tech tools have been developed to help detect cancer Magnetic Resonance Imaging (MRI) Computerized axial tomography scanning (CT scan)

36.  Breast Cancer  Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider.  Colorectal Cancer  Colonoscopy starting at age 50  Stool sample testing  Cervical Cancer  All women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse  Age 30 & Age 70

37.  Prostate Cancer  Age 45 & 50  PSA test  Testicular Cancer  TSE

38.  Slash, burn, & poison  Cancer Treatments  Surgery to remove tumor  Chemotherapy  Radiotherapy  Researching genes and cell mutations  Immunotherapy  Cancer-fighting vaccines  Stem cell research

39.  Diabetes currently affects 23.6 million Americans.  Since 1980, incidence has increased over 50 percent among U.S adults.  Diabetes is up by almost 70 percent among those in their thirties.  7.8 percent of the population has some form of diabetes.  Approximately 225,000 people die each year from diabetes-related complications.  It is the sixth leading cause of death in the United States today.

40.  Diabetes Mellitus  Disease characterized by a persistently high level of sugar (glucose) in the blood  Pancreas fails to produce enough insulin or the body fails to use insulin effectively  Hyperglycemia—high blood glucose levels seen in diabetes

41.  In Healthy People, Glucose Is Taken Up Efficiently by Body Cells  Carbohydrates from the foods are broken down into a monosaccharide called glucose.  Liver and muscle cells store glucose as glycogen, then use it as needed to fuel metabolism, movement, and other activities  Pancreas—an organ located just beneath the stomach that secretes a hormone called insulin  Insulin—hormone secreted by the pancreas and required by body cells for the uptake and storage of glucose

42.  Types of Diabetes  Type 1 diabetes  Type 2 diabetes  Gestational diabetes

43.  Pre-Diabetes Can Lead to Type 2 Diabetes  A condition in which blood glucose levels are higher than normal, but not high enough to be classified as diabetes  Affects more than 25 percent of the adult population  A ticking time bomb; if it’s not “defused,” diabetes will eventually strike

45.  Diabetes Care Can Be Expensive  On average, health care costs for diabetics are $15,000 to $25,000 higher per year than for healthy patients.  The direct and indirect costs of treating diabetes in the United States total $174 billion per year.  The costs related to undiagnosed diabetes are unknown.

47.  The pursuit of influencing outcomes including: Public policy and resource allocation decisions within political, economic, and social systems and institutions that directly affect peoples lives  Major responsibility of health educators  Tool for social/political change