Chronic non communicable diseases

The impact of chronic diseases on lives of people is serious

Chronic non communicable diseases
Chronic non communicable diseases

      Today, chronic non-communicable diseases (NCDs), mainly cardiovascular diseases, cancers, type 2 diabetes and chronic respiratory diseases, represent a threat to human health and development. Globally these four diseases are the leading cause of death globally, causing an estimated 38 million deaths each year , 28 million occurred in low and middle income countries.

       These diseases are preventable. Up to 80% of heart diseases, stroke and types 2 diabetes and over a third of cancers could be prevented by eliminating common risk factors, mainly tobacco use, unhealthy diet, physical inactivity, and the harmful use of alcohol.

Cardiovascular disease (CVDs)

Cardiovascular disease (CVDs)
Cardiovascular disease (CVDs)

       Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. The major conditions are coronary heart disease, cerebrovascular disease (stroke), hypertension, heart failure, and congenital heart disease.

Rheumatic heart disease continues to be important health problem in many developing countries.

     Cardiovascular diseases are the number one cause of death globally. An estimated 17.2 million people died from CVDs in 2012, representing 31% of all global deaths mainly due to coronary heart diseases and stroke. Moreover, they are projected to remain the single leading cause of death by the year 2030.

Descriptive epidemiology


      Cardiovascular diseases are more probable to occur among the middle-aged and older men. This is due to accumulation of risk factors. Before menopause, men have more death rates than women due to protective effect of estrogen hormone in women.

The disease affects more persons

-With cardiovascular family history. This may be due to genetic factors or environmental factors.

Persons having the following risk factors:

Early initiation of smoking ( < 16 years of age ) is associated with the greatest risk. Cessation of smoking reduces the risk of coronary heart by 50-70%.

The possible mechanisms include:

60% of global population is engaged in sedentary lifestyle associated with modernization, urbanization, and mechanized transportation.

The risk of cardiovascular diseases increase with refined sugar, low fruit, low vegetable and fiber content as well as high saturated fat intake.

It damages both peripheral and coronary blood vessels. The risk of coronary heart disease is 2-3 times higher in diabetics than non-diabetics. This is due to the higher rates of atherosclerosis.

Hypertension (>140/90 mmHg) is a very important risk factor as it is of wide spread and relatively easy to control. Hypertension accelerates the atherosclerosis especially in the presence of hyperlipidemia.

Serum cholesterol level is an important risk factor for the incidence of coronary heart disease especially for levels >240 mg/dl. Low density lipoprotein (LDL) cholesterol is the most directly related to CHD. High density lipoprotein (HDL) is a protective factor. Estrogen tends to raise HDL-Cholesterol and lower LDL-Cholesterol, protection for women in reproductive age.

It is a modern worldwide epidemic that elevates the risk of both cardiovascular diseases and diabetes mellitus.

Type A behavior characterized by restlessness, hostility, impatience, urgency, etc … is associated with increased risk of cardiovascular disease than the calm ( type B behavior ).

In developed countries, cardiovascular diseases are more encountered among less educated and lower socioeconomic groups due to accumulation of risk factors. In developing countries they are more encountered among more educated and higher socioeconomic groups ( western lifestyle ).

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Prevention of cardiovascular diseases:

Primordial prevention is defined as prevention of the development of risk factors before they happen in the community. It is known that cardiovascular diseases occur in a large scale only if the basic underlying causes are present. Successful implementation of primordial prevention in the context of cardiovascular diseases and other chronic diseases requires that healthy behaviors become normative e.g. non-smoking society, attainment of ideal body weight, healthy diet and physical activity by the community members.

The tobacco free initiatives are one of the World Health Organization`s major public policy initiatives, commenced in May 1998 to reduce smoking and the harmful effects of the use of tobacco products on human health.

This is required to change lifestyles behaviors associated with cardiovascular diseases. Health education messages should include:

This includes:

This may include:

The goal of the program is to reduce the mean population blood pressure levels, where 2 to 3 mmHg decrease would produce a large reduction in the incidence of cardiovascular complications. This may be achieved through decreased salt intake, decreased alcohol consumption, regular physical activity and weight control.

It is important to monitor the level of cholesterol, and lipoprotein levels

(LDL and HDL) in the blood. A total cholesterol/HDL ratio of less than 3.5 has been recommended as a clinical goal for cardiovascular prevention.

This is needed to change lifestyle behavior and reduce weight. In case of smoking the person should be helped to break the smoking habit permanently. Nicotine chewing gum can be tried to wean them from smoking.


If the patient does not stop smoking, nothing else is worth doing!!

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