Chapter 11

Cardiovascular Disease, Diabetes, and Cancer: Reducing Your Risks

Copyright 2008 Pearson Education Canada

Cardiovascular Diseases
Cardiovascular Disease (CVD)
Leading cause of death in Canada 3rd leading cause of premature death under age 75 Death rates from CVD are declining: Medical advances

Educational programs

Copyright 2008 Pearson Education Canada

12-2

Types of Cardiovascular Diseases

Arteriosclerosis
Narrowing or hardening of arteries
Atherosclerosis: Fatty substances in lining of artery Plaque may block blood flow Affected by
Fluctuations in blood pressure Cholesterol and triglycerides
Copyright 2008 Pearson Education Canada

Cigarette smoking

12-3

Types of Cardiovascular Diseases

Coronary Heart Disease
Myocardial infarction (MI)
Coronary thrombosis

Collateral circulation
Congenital Heart Disease: 1 in 125 children

Angina Pectoris
Ischemia
Copyright 2008 Pearson Education Canada 12-4

Stroke
Blood supply to brain is interrupted
Stroke

Figure 12.2: Common Blood Vessel Disorders.

Copyright 2008 Pearson Education Canada

12-5

Types of Cardiovascular Diseases

Hypertension Essential hypertension (most common) Secondary hypertension Arrhythmias Irregularity in heartbeat (fast, slow) Can be triggered by caffeine, nicotine Congestive Heart Failure Heart muscle is damaged or overworked
Copyright 2008 Pearson Education Canada 12-6

Controlling Your Risks for Cardiovascular Diseases

Risks You Can Control (fig 12-3 in text)
Cigarette Smoking Exercise Dietary Intake and Obesity (Type 2 Diabetes) Certain drug therapy (ERT, ASA)

Risks You Cannot Control

Heredity, Sex, Age, Race
Copyright 2008 Pearson Education Canada 12-7

Women and Cardiovascular Disease

Symptoms in Postmenopausal Women
First sign is usually uncomplicated angina pectoris (chest discomfort rather than pain)

Women decline major procedures more often than men (social stigma, gender bias)

Symptoms more vague than in men

Pain in neck, jaw, or arms Heaviness in shoulders, back, pit of stomach Feeling out of breath, tired, sweating, nausea
Copyright 2008 Pearson Education Canada 12-8

New Weapons Against Heart Disease

Angioplasty versus Bypass Surgery
Bypass has longer recovery time
Angioplasty may not last long

Low-dose aspirin may be beneficial

Thrombolysis
Injection that dissolves clot
Copyright 2008 Pearson Education Canada 12-9

Diabetes: Incidence and Mortality

Characterized by high levels of blood sugar Rates almost doubled between 1996/97 and 2005; estimated that 4.9% of Canadians have diabetes Type 1: autoimmune disease that destroys the cells that make insulin

Type 2: insulin production is deficient or the body is unable to utilize all the available insulin
90-95% of all diabetes cases

linked to obesity and physical inactivity

Gestational: develops during pregnancy but may predispose to later type 2 diabetes
Copyright 2008 Pearson Education Canada 12-10

Diabetes: Incidence and Mortality

Understanding Risk Factors
Familial Age Mothers of babies weighing more than 4 kg African Canadians, First Nations, and Inuuit

Controlling Diabetes
Insulin drugs Lifestyle changes: weight, diet, physical activity
Copyright 2008 Pearson Education Canada 12-11

Diabetes: Incidence and Mortality

Complications Associated with Diabetes: CVD Eye disease and blindness

Kidney disease
Amputations

Pregnancy complications
Flu- and pneumonia-related deaths
Copyright 2008 Pearson Education Canada 12-12

Cancer Incidence and Mortality

Introduction >150,000 new cases in Canada diagnosed

>70,000 deaths
Mortality declining for males & women under age 70 Types of Cancer malignant, benign Classifications of Cancer Carcinomas Sarcomas Lymphomas Leukemia
Copyright 2008 Pearson Education Canada 12-13

Cancer Incidence and Mortality

What Causes Cancer?
External factors
Environmental - carcinogens

Internal Factors
Spontaneous errors during cell reproduction (oncogenes and protooncogenes)
Copyright 2008 Pearson Education Canada 12-14

Cancer Incidence and Mortality

Biological Factors Occupational and Environmental Factors Asbestos, nickel, arsenic, etc Radioactive substances, ionizing radiation Social and Psychological Factors Stress, negative emotions Chemicals in Food Nitrates, pesticide & herbicide residues
Copyright 2008 Pearson Education Canada 12-15

Cancer Incidence and Mortality

Smoking
Leading cause of preventable death in the world
In Canada - nearly 1 in 5 deaths annually

Obesity
More common among people overweight Risk increases as obesity increases High BMI and death rates for certain cancers
Copyright 2008 Pearson Education Canada 12-16

Cancer Incidence and Mortality

Figure 11.4: Suspected Causes of Cancer

Copyright 2008 Pearson Education Canada 12-17

Types of Cancer
Lung Cancer

Leading cause of premature death due to cancer

Only 13% live 5 years beyond diagnosis Rates improve to 47% with early detection
researchers theorize: 90% of all lung cancers could be avoided by not smoking

Copyright 2008 Pearson Education Canada

12-18

Types of Cancer
Breast Cancer: risk increases with age Prevention recognition of early symptoms physical activity

regular self examination & mammography

Treatment many options: lumpectomy, mastectomy, radiation, chemotherapy

Copyright 2008 Pearson Education Canada

12-19

Figure 11.5: Selected Surgical Procedures for Diagnosed Breast Cancer

Copyright 2008 Pearson Education Canada

12-20

Types of Cancer
Prostate Cancer Most common cancer in males today Estimated 20,7000 Canadian men were diagnosed in 2006 (~4,200 deaths) Colon and Rectum Cancer 40+ with family history are at increased risk Warning signals, e.g. blood in the stool, rectal bleeding, etc. Testicular Cancer Ages 17-34 at greatest risk Cause unknown
Copyright 2008 Pearson Education Canada 12-21

Types of Cancer

Figure 11.6: Testicular Self-Exam

Copyright 2008 Pearson Education Canada

12-22

Types of Cancer
Skin Cancer Common: basal or squamous cell skin cancers Virulent: malignant melanoma

ABCD Rule about melanoma

Oral Cancer

Lips, cheeks, gums, floor of mouth, tongue, tonsils

Tobacco - smoking, chewing, or dipping
Copyright 2008 Pearson Education Canada 12-23

Types of Cancer
Ovarian Cancer Enlargement of abdomen, common sign Prevention: annual pelvic exams Endometrial (Uterine) Cancer Pap test for early detection of cervical cancer

Warning: abnormal bleeding

HBV, HCV, and Liver Cancer chronic, inflammation of liver
Copyright 2008 Pearson Education Canada 12-24

Cancers Seven Warning Signs

1. 2. 3. 4. Change in bowel or bladder habits A sore that does not heal Unusual bleeding Thickening or lump (breast or other body part) 5. Indigestion or difficulty swallowing 6. Distinct change in wart or mole 7. Nagging cough (hoarseness)
Copyright 2008 Pearson Education Canada 12-25