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Unit 10

Chronic Disease Study Guide

Chronic disease
- Any disease that develops over time
Examples of chronic disease
- Cardiovascular disease (CVD)
- Cancer
- Diabetes
- Osteoporosis

Leading cause of death in the U.S.
- 2 in 5 die of CVD in the United States, this is approximately 1 million people per year, about 2,500 per day.
Types of CVD
- Artherosclerosis:
  - Progressive narrowing and hardening of arteries due to formation of plaque
  - Plaque = Accumulation of fat, connective tissue and other substances
- Coronary artery disease (CAD):
  - Responsible for most heart related deaths
- Myocardial infarction: “Heart Attack”-
  - Death of a region of the myocardium do to insufficient blood supply
- Angina pectoris
  - Severe chest pains
  - MI… but without the heart attack
- Stroke
  - 4 million have had a stroke
  - Stroke kills about 158,000 per year
- Thrombus
  - Blood clot attached to plaque on artery wall
  - Can be treated with clot-dissolving drugs

Cigarette smoking
- Cigarette smoking facilitates formation of plaque, increase likelihood of clot formation
- 2x the risk
- 2nd hand smoke increases risk by 30%
Hypertension
- Blood pressure > 140/90
- 1 in 4 Americans affected by hypertension
- Hypertension increases blood pressure and places stress on arteries
Elevated cholesterol
- HDL < 45
  - “Good”: Picks up cholesterol in the body and delivers it through the blood to the liver, where it is processed and excreted
- LDL > 130
  - “Bad”: Delivers cholesterol to cells, responsible for buildup
- What is the desired total cholesterol level?
Physical inactivity
Obesity
Contributing factors
- Age
- Sex
- Diabetes
- Stress

Number 2 Cause of Death in U.S.
Cancer Defined
- Uncontrollable, abnormal cell growth
- Over 100 different types
Tumors
- benign = Non-cancerous
- malignant = Cancerous
- metastasis = New cancerous cell growth

Cancer	Symptoms	Risk Factors	Treatment
Lung	chest pain persistent cough bloody sputum	smoking 2nd hand smoke occupational exposure	surgery radiation chemotherapy
Prostate	pain during urination blood in urine referred back pain	Male genetics age dietary fat	surgery radiation chemotherapy
Breast	unusual breast lump, swelling nipple discharge breast pain, tenderness	female age >40 genetics early menarche	surgery radiation chemotherapy
Colo-rectal	rectal bleeding bloody stool irritable bowels	age > 40 genetics high fat/low fiber diet	surgery radiation chemotherapy

Major Cancer-Causing Agents

Diabetes mellitus
- Abnormally high blood sugar levels
- Also highly susceptible to atherosclerosis, CAD, increase BP, infection, blindness and chronic kidney disease
Insulin
- Hormone produced in the pancreas that facilitates the transport of glucose from the blood to the muscle, adipose tissue and liver
- Insulin “opens the gates” of the cells to glucose, thereby decreasing blood sugar levels and making glucose available for energy
- Normal blood glucose levels are approximately 80-110 mg/dl of blood
Type 1
- Formerly known as insulin-dependent
- Occurs mostly slim children and adults
- Individuals unable to produce insulin
Type 2
- Formerly non-insulin-dependent
- Resistance to the glucose transport effect of insulin
- Most common in obese individuals over 40
- 90% have type 2 diabetes

Genetics
- Tendency to develop appears to be present at birth
- A positive family history is the only known risk factor for Type I
Obesity and physical inactivity
- > 20 lbs. Overweight = “at risk”
Age > 40 are more susceptible to type 2
Ethnicity
- E.G., African Americans, Latinos and native Americans are all especially prone
  - The reason for this is unclear in the research, but may be linked to lifestyle patterns of diet and physical activity

Type 1
- Frequent urination
- Excessive thirst
- Extreme hunger
- Weight loss
Type 2
- Same as type 1
- Hard-to-heal skin
- Tingling/ numbness in hands or feet

Defined
- Low bone mineral content (BMC)
- Increased susceptibility to bone fracture
Frequency
- ~25 million Americans--80% are elderly women
- Over half of women 50 years or older can expect to suffer some sort of fracture due to Osteoperosis

Genetics
Frame size
- Thin or small frame at higher risk
Sex
- Women 4 x more likely to develop
- Frame size and estrogen decrease after menopause
Race
- White & Asian women suffer 2-3 x more
Age
- Peak bone mass at 15 years
- 1% bone loss a year beginning at age 30
- Females: after menopause, BMC will decrease 2-5% for about five years, and return to 1% after that 5 years
Low estrogen and testosterone levels
- E.g., endurance athletes
Physical inactivity
Inadequate calcium intake
Smoking
Alcohol consumption
- Studies link high alcohol intake with osteoperosis.

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