Chronic Disease

Question 1

What is chronic disease?

Answer 1

Chronic = develops slowly and persists for a long period of time.
Chronic conditions = cardiovascular diseases, cancers, and diabetes.
Start and are undetected in early adulthood or even childhood.
Once diagnosed impossible to completely cure most chronic conditions.
Non-communicable.
Many kinds…

Question 2

Three types of diabetes…

Answer 2

Type 1, type 2, gestational

Question 3

Type 1

Answer 3

10%, decreasing
Typically diagnosed in childhood
Pancreas unable to produce insulin which is responsible for controlling glucose in the body.
Glucose circulates in the blood and damages blood vessels, which results in an increased risk of infections, since nutrients and oxygen are not delivered where they need to go.

Question 4

Type 2

Answer 4

90%, increasing
Typically diagnosed in adults.
Pancreas doesn’t produce enough insulin OR insulin produced is not used effectively.
Glucose builds up in the body, rather than being used for energy.

Question 5

Gestational

Answer 5

Temporary condition during pregnancy.
Occurs in 2-4% of pregnancies.
Leads to increased risk of child/mother developing diabetes, when not managed.

Question 6

Signs and Symptoms of Diabetes

Answer 6

The 3 P’s = unusual thirst (polydipsia), frequent urination (polyuria), and intense hunger (polyphagia).
Weight change (gain or loss)
Extreme fatigue or lack of energy
Frequent or recurring infections (bacteria loves sugar).
Cuts and bruises that are slow to heal.
Tingling or numbness in the hands or feet.
Trouble getting or maintaining an erection.

Question 7

Personal Cost of Diabetes

Answer 7

Reduced quality of life and increased likelihood of complications such as heart disease, stroke, kidney disease, blindness, amputation and erectile dysfunction.
About 80% of people with diabetes will die as a result of heart disease or stroke.
Canadian adults with diabetes are twice as likely to die prematurely, compared to people without diabetes.

Question 8

The Financial Cost of Diabetes

Answer 8

People with diabetes incur medical costs that are 3-4 times higher than those without diabetes.
As of 2020, it is estimated that diabetes cost the Canadian healthcare system $16.9 billion a year.

Question 9

Treatment for Diabetes

Answer 9

The evidence is clear that insulin sensitivity, while type 2 diabetes is prevented or delayed, in most people when they lose body fat
-an increase of moderate to vigorous physical activity can impact change even when they don’t lose much weight.
Maintain a healthy diet, without excessive sugars.
Nonetheless, drugs that regulate glucose are often needed in the treatment of people with type 2 diabetes.
-they either reduce glucose output or reduce insulin resistance.

Question 10

What is cardiovascular disease?

Answer 10

Broad term referring to any disease that has to do with the heart and blood vessels.

Question 11

Coronary Heart Disease (CHD)

Answer 11

Plaque (a waxy substance) builds up in the arteries (ie. atherosclerosis) that lead to the heart, and eventually harden/rupture.
Results in oxygen rich blood not adequately reaching the heart.
Heart muscles weaken and are unable to pump enough blood to the rest of the body.
Angina (large plaques) cause chest pain due to lack of oxygen.
Myocardial infarction (heart attack) typically when the plaque ruptures and causes a blockage.

Question 12

Risk Factors for CHD

Answer 12

Genetic susceptibility
Male sex
Age
Elevated serum cholesterol = serum cholesterol is the total amount of cholesterol found in your blood
Low levels of HDL
Smoking
High blood pressure
Obesity
Diabetes
Physical inactivity

Question 13

Exercise and CHD

Answer 13

Exercise adaptations include lowered blood cholesterol and triglycerides which reduce the risk of atherosclerotic plaques.
-exercise increses HDL which removes other types of cholesterol from the bloodstream.
Lower heart rate and blood pressure, and these regulate oxygen demand in the heart.
-when the heart is working too fat, it doesn’t have time to fill up with blood.
More efficient oxygen delivery and utilization.
Autopsy studies show…
-physically active men who ahd athersclerosis/plaque buildup still had large lumens (open space in artery)
-monkeys fed large amounts of high cholesterol diets but lots of PA had healthier arteries than monkeys who didn’t exercise.

Question 14

Hypertension

Answer 14

High blood pressure.
Six million Canadian adults (one in five) have high blood pressure, representing 19% of the adult population.
Hypertension is the most common reason to visit a doctor.
Hypertension is the number one reason for taking medication.

Question 15

Risk Factors for Hypertension

Answer 15

Being overweight/obese
Physical inactivity
Using tobacco
Age
Too much salt/sodium in your diet
Too little potassium in your diet
Drinking too much alcohol
Stress
Certain chronic conditions

Question 16

Overweight/Obese and Hypertension

Answer 16

The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues.
As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.

Question 17

Physical Inactivity and Hypertension

Answer 17

People who are inactive tend to have higher heart rates.
The higher your heart rate, the harder your heart must work with each contraction and the stornger the force on your arteries.
Lack of physical activity also increases the risk of being overweight.
Linked to being overweight/obese.

Question 18

Using tobacco and Hypertension

Answer 18

Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls.
This can cause your arteries to narrow, increasing your blood pressure.

Question 19

Too Much Sodium in your Diet and Hypertension

Answer 19

Too much sodium in your diet can cause your body to retain fluid which increases blood pressure.

Question 20

Too little potassium in your diet and Hypertension

Answer 20

Potassium helps balance the amount of sodium in your cells.
If you don’t get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.

Question 21

Drinking too much alcohol and hypertension

Answer 21

Over time, heavy drinking can damage your heart.
Having more than two drinks a day can raise your blood pressure.

Question 22

Stress and Hypertension

Answer 22

High levels of stress can lead to a temporary, but dramatic increase in blood pressure.
If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.

Question 23

Certain chronic conditions and Hypertension

Answer 23

Certain chronic conditions also may increase your risk of high blood pressure, including high cholesterol, diabetes, kidney disease and sleep apnea.

Question 24

Blood Pressure

Answer 24

Measure of the pressure of blood against arteries.
Systolic and diastolic components.

Question 25

Systolic BP

Answer 25

measures the amount of pressure that blood exerts on arteries and vessels while the heart is beating

Question 26

Diastolic BP

Answer 26

the pressure that is exerted on the walls of the arteries in between heart beats when the heart is relaxed

Question 27

Systolic/Diastolic Measurements

Answer 27

Normal = <120/80 mmHg
Pre-hypertension = 120-139/80-90 mmHg
Stage 1 hypertension = 140-149/90-99 mmHg
Stage 2 hypertension = >160/100 mmHg

Question 28

Health Effects of Hypertension

Answer 28

Over time high blood pressure…
-can damage blood vessel walls causing scarring that promotes the build-up of fatty plaque.
-strains the heart and eventually weakens it (chronic heart failure)
-very high blood pressure can cause blood vessels in the brain to burst resulting in stroke

Question 29

Prevention of Hypertension

Answer 29

Engaging in regular exercise reduces risk of hypertension by 30-50%
Diet is also an important consideration such as reduced salt and saturated/trans fat intake

Question 30

Cerebrovascular Disease

Answer 30

Are conditions that develop as a result of problems with the blood vessels that supply the brain.
Is also a type of cardiovascular disease that affects the brain’s blood vessels.

Question 31

Mortality of Cerebrovascular Disease

Answer 31

Stroke is the third leading cause of death in Canada.
6% of all deaths in Canada are due to stroke.
-cancer and heart disease are first and second.

Question 32

Types of Cerebrovascular Disease

Answer 32

There are a number of different types of cerebrovascular disease.
Most common types include stroke, transient ischemic attack (TIA), and vascular dementia.

Question 33

Stroke

Answer 33

A serious medical condition where the blood supply to the brain is interrupted.

Question 34

Transient Ischemic Attack (TIA)

Answer 34

a temporary fall in the brain’s blood supply, resulting in a lack of oxygen to the brain.
Is a sign that a stroke is coming.

Question 35

Vascular dementia

Answer 35

Problems with the blood circulation, leading to parts of the brain not receiving enough blood and oxygen

Question 36

Stroke Risk Factors

Answer 36

Hypertension (primary factor)
Age
Smoking
Gender
Family history
Diabetes and obesity
CHD
Physical inactivity

Question 37

Hypertension and Stroke

Answer 37

Primary factor
Men in the Framingham Heart study who had hypertension were 4 times more likely to have a stroke.
Young adults 5 times higher.

Question 38

Age and Stroke

Answer 38

stroke risk doubles for each decade after 55.
2/3 strokes happen in people over 65.

Question 39

Smoking and Stroke

Answer 39

Increased risk for all types.
Leads to arterial damage and atherosclerosis.

Question 40

Gender and Stroke

Answer 40

Women have higher stroke risk, are more likely to die from a stroke than men.

Question 41

CHD and Stroke

Answer 41

Atherosclerosis underlies both coronary heart disease and carotid artery disease which means plaque reduces blood flow to your brain.

Question 42

Etiology of Stroke

Answer 42

A stroke occurs when a blood clot blocks an artery or a blood vessel breaks, interrupting blood flow to an area of the brain.
-when either of these things happen, brain cells begin to die and brain damage occurs.
When brain cells die during a stroke, abilities controlled by that area of the brain are lost such as speech, movement and memory.
Much of the pathophysiology of a stroke involves atherosclerotic disease (CHD).

Question 43

Physical Activity and Stroke

Answer 43

2008 physical activity guidelines advisory committee determined:
-moderately active people have a 25-30% reduced chance of stroke including ischemic and hemorrhagic.
Physical activity may reduce brain cell damage after a stroke (evidence from animal studies only).

Question 44

What is cancer?

Answer 44

Begins in the cells.
Normally, cells are instructed by genes to grow, work, reproduce, and die.
Sometimes, the instructions get mixed up, and cells mutate or reproduce rapidly and build up and/or spread to other parts of the body.
Tumors are either benign (non-cancerous) and don’t spread or malignant (cancerous) and spread to other parts of the body and are life-threatening.
Cancers named after the part of the body they start.

Question 45

Risk Factors for Cancer

Answer 45

Different cancers have different risk factors though some risk factors are associated with several cancers.
Smoking is associated with cancers of the lung, mouth, throat, larynx, etc.
Excessive sun exposure and burning.
Physical inactivity = physical activity moves food through the digestive system faster, less time for harmful substances to be in contact with bowel.
The pathophysiology that leads to specific site cancers is less well understood than for some other chronic diseases such as CVD and type 2 diabetes.

Question 46

Physical Activity and Cancer

Answer 46

The earliest epidemoiologic studies postulating that physical activity may reduce the risk of developing cancer were published in 1922
-men who worked in physically demanding occupations had lower cancer mortality rates than men in less demanding ones.
Subsequently, there was little research interest in this topic until the 80’s and 90’s.
Physical activity reduces the risks of developing colon and breast cancers.
Evidence suggests for lower risks of lung, endometrial, and ovarian cancers associated with physical activity.