FINALS CPHM

• 4 Major Non-Communicable Diseases (NCDs)

  • Cardiovascular diseases
  • Cancer
  • Chronic Obstructive Pulmonary disease
  • Diabetes mellitus
• In the Philippines, urbanization and lifestyle changes have brought about a considerable change on the health status
• Globalization and social change influenced the spread of NCDs
• Health educator


  Essential tool to achieve community health, concerned with promoting health as well as reducing behavior-induced diseases
• Health educator aims to

  • Inform the people
  • Motivate the people
  • Guide the people into action
• Hypertension (HPN) or High Blood Pressure


  Defined as sustained elevation in mean arterial pressure, major risk factor for the development of other Cardiovascular Diseases like Coronary Heart Disease or Stroke, not a single disease state but a disorder with many causes, a variety of symptoms and a range of responses to therapy
• Types of Hypertension


  • Primary Hypertension
  • Secondary Hypertension
• Primary Hypertension


  No definite cause but it is attributed to atherosclerosis, also known as Essential hypertension or Idiopathic hypertension
• Secondary Hypertension


  Result from other diseases that leads to hypertension such as renal diseases
• Risk Factors for Hypertension

  • Family History
  • Age
  • Race
  • High salt intake
• Lifestyle Factors for Hypertension

  • Obesity
  • Excess alcohol consumption
  • Stress
• Prevention of Hypertension


  • Encourage proper nutrition
  • Smoking cessation
  • Regular check-ups
• Coronary Artery Disease (CAD)


  Heart disease caused by impaired coronary blood flow, also known as Ischemic Heart Disease, can cause myocardial infarction (heart attack), arrhythmias, heart failure and sudden death, caused by atherosclerosis (thickening of the inside wall of the arteries due to deposition of fat-like substance)
• Risk Factors for Coronary Artery Disease

  • Family History
  • Age
  • Race
  • Sex
  • Elevated blood lipids (Low Density Lipoprotein)
  • Hypertension
  • Smoking
  • Diabetes Mellitus
  • Obesity
  • Stress
• Prevention of Coronary Artery Disease

  • Regular exercises & physical activity
  • Proper nutrition - limit salt intake, limit saturated fats
  • Stop smoking
  • Early diagnosis & prompt treatment
• Cerebrovascular Disease or Stroke


  Loss of alteration of bodily 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 the brain cells becomes permanent and tissue dies in the affected region resulting in cerebral infarction, one of the leading causes of disability

  
• Types of Stroke


  • Thrombolytic stroke
  • Embolic stroke
  • Hemorrhagic stroke
• Thrombolytic stroke


  Usually occurs in atherosclerotic blood vessel commonly seen in older people
• Embolic stroke


  Caused by a clot that travels from somewhere else in the body, usually from the heart
• Hemorrhagic stroke


  Most fatal type of stroke, rupture of intracerebral blood vessel
• Other causes of Stroke

  Aneurysms, trauma
• Cancer


  Develops when cells in a part of the body begin to grow out of control, cancer cells continue to grow and divide even when there is no need to do so, they compete with normal cells for the blood supply and nutrients, metastasis is when cancer cells get into the bloodstream or lymph vessels and can travel to other parts of the body and begin to grow and replace normal cells

  
• Risk Factors for Cancer


  • Hereditary/family history
  • Carcinogens - chemical, environmental agent, radiation
• Examples of Carcinogens


  • Polycyclic hydrocarbons - chemicals found in cigarette smoke, industrial agents and in smoked foods
  • Benzopyrene - produced when meat and fish are charcoal broiled or smoked, also produced when food is fried in fat that has been reused repeatedly
  • Nitrosamines - powerful carcinogens used as preservatives in foods like tocino, longanisa, bacon, hotdogs
  • Radiation - UV rays from sunlight, x-rays
  • Viruses
  • Aflatoxin - found in peanuts and peanut butter
• Prevention of Cancer


  • Smoking cessation
  • Encourage proper nutrition - increase intake of dietary fibers, limit consumption of smoked, charcoal-broiled, salt cured foods
  • Drink alcohol beverages in moderation
  • Control obesity
  • Early diagnosis and prompt treatment
• Diabetes Mellitus


  Genetically and clinically heterogeneous group of metabolic disorder characterized by glucose intolerance with hyperglycemia present at time of diagnosis
• Types of Diabetes Mellitus

  • Type I - Insulin dependent Diabetes Mellitus (IDDM)
  • Type II - Non-insulin Dependent Diabetes Mellitus (NIDDM)
  • Gestational Diabetes
• Type I Diabetes Mellitus

  Characterized by absolute lack of insulin due to damaged pancreas, dependent on insulin injections, genetic, environmental or maybe acquired
• Type II Diabetes Mellitus


  More common, 90-95% of all person with obesity and diet, possible cause include impaired insulin secretion and increased hepatic glucose production, usually in older and overweight persons
• Gestational Diabetes


  Develops during pregnancy and may lead to type II DM
• Risk Factors for Type II Diabetes Mellitus


  • Family history
  • Overweight and obesity
  • Sedentary lifestyle
  • Hypertension
• Complications of Diabetes Mellitus

  • Diabetic ketoacidosis
  • Hypoglycemia
  • Chronic renal disease
  • Blindness/retinopathy
  • Coronary Artery Disease/Stroke
  • Foot ulcers
• Prevention of Diabetes Mellitus

  • Encourage proper nutrition
  • Maintain body weight and prevent obesity
  • Promote regular exercise
  • Smoking cessation - DM patients who smoke have higher risk of heart attack and stroke
• Screening for Diabetes Mellitus


  • Ask the patient - Family history of diabetes, Polyuria, Polydypsia, Polyphagia, Unexplained weight loss
  • Blood tests - Fasting blood sugar, 2 hours post prandial test
• Chronic Obstructive Pulmonary Disease (COPD)

  Major cause of chronic morbidity and mortality worldwide, 4th leading cause of mortality, disease characterized by airflow limitation that is not fully reversible, the airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases
• Causes and Risk Factors of COPD

  • Smoking
  • Chronic bronchitis
  • Emphysema
  • Age
• Primary Symptoms & Primary Diagnosis of COPD

  • Cough
  • Sputum production
  • Dyspnea
• Complications of COPD


  • Respiratory failure
  • Cardiovascular disease
• Bronchial Asthma


  A chronic disease (chronic inflammation = hyperresponsiveness of airways), inflammatory disorder of the airways, these episodes are reversible spontaneously or by treatment
• Host Factors for Asthma

  • Genetic predisposition
  • Atopy/allergy
  • Airway hyperresponsiveness
  • Gender
  • Race/ethnicity