Chronic Disease Prevention

Definition

Chronic disease describes illnesses that are prolonged and require ongoing medical attention and management.

Description

The Centers for Disease Control and Prevention (CDC) reports on disease statistics and trends. In 2014, the seven leading causes of death were (in order from most deaths to least):

With the exception of accidental death, each of the above causes of death can be prevented or at least have the risk and severity of disease lowered with a preventive approach. Many lifestyle factors are involved in most chronic diseases. For example, stopping (or never starting) smoking can help prevent chronic lower respiratory disease. The medical community, government, and community and public health agencies also work to educate people about preventing or managing chronic diseases and help provide programs to lower risk, such as making sure insurance pays for mammograms to detect breast cancer.

Description

Not only are many chronic diseases causes of death, but they cost the health care system a great deal of money to treat, and they can affect the quality of life of people who have them. The CDC estimates that in 2012, nearly half of all adults, or about 117 million people, had chronic diseases and conditions. Some of the common health behaviors that increase risk of chronic disease include lack of physical activity (with fewer than half of adults meeting the suggested recommendations for regular exercise), along with smoking, uncontrolled high blood pressure, obesity, and drinking alcohol.

Prevention

Heart disease prevention

Recorded rates of death from heart disease (cardiovascular, or heart and blood vessel, disease), the leading killer in the United States, contributed to 229.9 deaths per 100,000 Americans in 2013. Preventing heart disease requires key lifestyle changes or adaptations. The Mayo Clinic, along with other leading research hospitals, proposes the cessation of smoking as a number one step in the prevention of this fatal disease. Approximately one-third of all heart-disease deaths are directly attributed to cigarette smoking or exposure to second-hand smoke.

After smoking cessation, the medical and scientific communities suggest the introduction of near-daily moderate aerobic exercise for 30 to 60 minutes, such as brisk walking. Appropriate aerobic exercise keeps a heart healthy, reduces stress hormones that negatively affect health in important ways, and works to keep body mass, cholesterol, and blood pressure under control. Consistent exercise reduces the likelihood of obesity, which is directly linked to heart attack and other illness.

Next, researchers and medical professionals stress the importance of maintaining a heart healthy diet low in saturated and trans fats and sodium, and rich in vegetables, fruits, and whole grains. Because many processed meats and most full-fat dairy products are high in saturated fats, the recommendations are to eat lean fresh meats and fish, which often include heart-healthy omega-3 fatty acids, and low-fat dairy products. Salmon and mackerel are especially heart-friendly fish. Beans are a good source of low-fat protein and are favored on both heart conscious and lower fat diets.

Maintaining a healthy weight is important for the prevention of heart disease and other chronic diseases. Obesity can lead to high blood pressure, high cholesterol, and diabetes. Calculating one's body mass index (BMI) is a useful tool in determining health in relationship to weight; BMI gauges whether an individual has a healthy or unhealthy percentage of body fat by evaluating height and weight proportions.

Cancer prevention

Cancer appears second on the CDC's list of leading causes of death, however, the World Health Organization (WHO) states that of 30%–50% of cancer deaths are preventable. The WHO cited smoking, harmful alcohol use, poor diet, and lack of exercise as primary risk factors for cancer. Although information about causes of cancers and strategies for cancer prevention can be extensive, the best way to prevent cancer involves avoiding known risk factors and seeing a doctor for early cancer screenings. Much of the cancer risk is genetic, or inherited, but some people can carry the genetic factors that cause cancer, but only seem to develop the disease when heredity is affected by unhealthy lifestyle choices. It is wise to know hereditary risks for cancer as well as risk factors related to lifestyle and environment.

The WHO lists the most common risk factors for cancer as the following:

Awareness of these risk factors, consistent avoidance of them wherever possible, and regular cancer screenings are the best course of action to lower the risks and catch cancer early, potentially preventing death and chronic illness.

Stroke prevention

Cerebrovascular infarction, is the medical term for what is more commonly called stroke. A stroke occurs when blood flow to an area of the brain is interrupted because a blood vessel of the brain is obstructed or bursts. There are two main types of stroke: ischemic and hemorrhagic stroke. Ischemic stroke occurs when a blood vessel supplying blood directly to the brain is blocked by a blood clot. Hemorrhagic stroke occurs when a blood vessel of the brain suddenly ruptures due to weakness. Both types of stroke can create severe damage in the brains of patients who survive them.

Although certain risk factors for strokes cannot be prevented (e.g., age, gender, ethnicity), other factors that increase the likelihood of stroke can be modified or prevented to help lower the possibility of a stroke event. Preventive measures for stroke are listed by the Mayo Clinic as:

KEY TERMS
Alzheimer's disease—
A degenerative brain disease that is the most common form of dementia and that usually starts in old age, causing progressive memory loss, impaired thinking, disorientation, and changes in personality and mood, leading, in advanced cases, to a profound decline in cognitive and physical functioning.
Body mass index (BMI)—
A measure of body fat that is the ratio of the weight of the body in kilograms to the square of its height in meters.
Diabetes mellitus—
A common form that develops especially in adults and most often in obese individuals and that is characterized by hyperglycemia resulting from impaired insulin utilization coupled with the body's inability to compensate with increased insulin production.
Dementia—
Usually a progressive condition marked by deteriorated cognitive functioning often with emotional apathy.
Hemorrhagic—
High discharge of blood from the blood vessels.
HPV infection—
Infection by the human papillomavirus through sexual transmission.
Insulin—
A protein hormone that is essential for the metabolism of carbohydrates, lipids, and proteins. Insulin also regulates blood sugar levels by facilitating the uptake of glucose into tissues; promoting its conversion into glycogen, fatty acids, and triglycerides; and by reducing the release of glucose from the liver. The disease diabetes mellitus is caused by the insufficient production of insulin.
Ischemia—
Deficient supply of blood to a body part, such (as the heart or brain, due to obstruction of the inflow of arterial blood.
Omega-3 fatty acids—
Any of several polyunsaturated fatty acids found in leafy green vegetables, vegetable oils, and fish.
Chronic lower respiratory disease prevention

Chronic lower respiratory diseases are high on the CDC's list of causes of death, however, knowledge of these diseases offers key insights into useful prevention steps. Among the more frequently diagnosed in this category of diseases is chronic obstructive pulmonary disease (COPD). COPD is comprised of two main types of illness: chronic bronchitis and emphysema. With chronic bronchitis, a patient experiences a long-term mucus-producing cough, along with other symptoms such as fatigue, chronic upper respiratory infection, and shortness of breath or wheezing. The symptoms of emphysema are nearly identical except that the lungs are being destroyed in a degenerative fashion.

COPD is most frequently caused by cigarette smoking, but other causes of the disease are repeated exposure to gases or fumes, secondhand smoke, and repeated inhalation of smoke from cooking without proper ventilation.

Diabetes prevention

Diabetes mellitus is the most common form of the disease and is also called type 2 diabetes, or adult-onset diabetes. Diabetes mellitus is essentially a problem related to insulin, a hormone used by the body to metabolize glucose. People with type 2 diabetes have problems producing enough insulin, or their cells are not responding to the insulin their bodies manufacture. When this happens, carbohydrates, sugars, and starches cannot be broken down adequately into the important glucose cells required for energy and proper function. Complications from diabetes can eventually lead to nerve, kidney, and heart damage.

Knowing one is at risk for diabetes and working to prevent its onset is crucial. Getting adequate amounts of exercise, eating a healthy and balanced diet, and maintaining a healthy weight are the key preventions for type 2 diabetes.

Alzheimer's disease prevention

Alzheimer's disease (AD) is the most frequently occurring type of dementia, which is the progressive loss of certain thinking, reasoning, and emotional skills. Most notably, AD causes problems with memory, but it also impairs thought and behavior. Despite what many people believe, Alzheimer's is not a normal part of aging, and the disease can affect individuals who are not yet elderly. Early onset AD occurs in 5% of individuals as early as in their 40s and 50s.

QUESTIONS TO ASK THE DOCTOR

In AD the symptoms of dementia gradually worsen over time until what begins as occasional loss of memory and the onset of cognitive issues becomes an inability to carry on conversations or respond to their environment. Individuals with AD can live up to 20 years after symptoms first appear, but, on average, they live for about 8 years after onset.

Risk factors for AD are primarily based on genetics and aging. There is some indication that maintaining a healthful approach to aging is an important part of prevention. Diet, regular exercise, and especially regular mental exercise help lower risk for the disease and delay symptom onset. Controlling other chronic diseases, such as diabetes and high blood pressure are steps toward being healthier overall and helping to prevent the dementia.

Resources

BOOKS

Remington, Patrick L., Ross C. Brownson, and Mark V. Wegner. Chronic Disease Epidemiology, Prevention, and Control. Washington, DC: American Public Health Association, 2016.

WEBSITES

Alzheimer's Association. “What Is Alzheimer's?” Alz.org . http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp (accessed March 1, 2017).

Centers for Disease Control and Prevention. “Chronic Disease Overview.” US Department of Health & Human Services. https://www.cdc.gov/chronicdisease/overview (accessed March 1, 2017).

Centers for Disease Control and Prevention. “Leading Causes of Death.” US Department of Health & Human Services. https://www.cdc.gov/nchs/fastats/leadingcauses-of-death.htm (accessed March 1, 2017).

Mayo Clinic Staff. “Strategies to Prevent Heart Disease.” Mayo Foundation for Medical Education and Research. http://www.mayoclinic.com/health/heartdisease-prevention/WO00041 (accessed March 1, 2017).

Oregon Health and Science University. “OHSU Scientists Identify Potential Target for Preventing and Treating Alzheimer's Disease.” News Medical Life Sciences. http://www.news-medical.net/news/20161201/OHSU-scientistsidentify-potential-target-for-preventing-and-treatingAlzheimers-disease.aspx (accessed March 1, 2017).

PubMedHealth. “Cerebrovascular Accident (Stroke).” US National Library of Medicine. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001740 (accessed March 1, 2017).

Robinson, Jennifer. “Smoking and Heart Disease.” Webmd. com. http://www.webmd.com/smoking-cessation/quitsmoking-heart (accessed March 1, 2017).

World Health Organization. “Cancer: Key Facts About Cancer.” WHO.int. http://www.who.int/cancer/about/facts/en/index.html (accessed March 1, 2017).

ORGANIZATIONS

Alzheimer's Association, 225 N. Michigan Ave., Fl. 17, Chicago, IL, 60601, (800) 272-3900, info@alz.org, http://www.alz.org/index.asp .

American Diabetes Association, 2451 Crystal Dr., Ste. 900, Arlington, VA, 22202, (800) DIABETES (342-2383), AskADA@diabetes.org, http://www.diabetes.org .

Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, 30329-4027, (800) 232-4636, http://www.cdc.gov .

Julie Jordan Avritt
Revised by Teresa Odle, BA, ELS

  This information is not a tool for self-diagnosis or a substitute for professional care.