Non communicable diseases . An overview of prevention on ncds

A brief overview of non communicable diseases

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2. NON-COMMUNICABLE DISEASES (NCDs) Dr. Mahnoor 2

3. Learning objectives Explain the concept and significance of non-communicable diseases (NCDs). Classify non-communicable diseases based on their types and characteristics. Identify the risk factors associated with NCDs and categorize them into modifiable and non-modifiable factors. Describe general prevention strategies for reducing the burden of non-communicable diseases.

4. What non communicable diseases are you aware of? 4

5. Non communicable disease “An impairment of bodily structure and/or function that necessitates a modification of the patients normal life, and has persisted over an extended period of time 5

6. Characteristics Chronic conditions are characterized by the following: – Do not result from an (acute) infectious process – Are “not communicable” – Cause premature morbidity, dysfunction, and reduced quality of life – Usually develop and progress over long periods – Often initially insidious – Once manifested there is usually a protracted period of impaired health

7. Types Cardiovascular diseases Cancer Chronic lung diseases Diabetes Musculoskeletal disorders Neurological disorders Accidents

8. Epidemiology of NCDs 60% of global mortality due to NCDs 80% in low and middle income countries Incidence higher in poor than rich countries Disease of the working age group 80% cardiovascular diseases and type II diabetes are preventable 40% cancers are preventable 8

9. Common Risk Factors of NCDs 9

10. Common Risk Factors for NCDs Tobacco use Alcohol abuse Failure to obtain preventive health services Life-styles changes Insufficient physical activity Unhealthy diet Overweight & obesity Environmental risk factor Occupational hazards Air & water pollution weapons Stress 10

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12. Modifiable vs non modifiable risk factors Modifiable Non modifiable A risk factor that can be reduced or controlled by intervention, thereby reducing the probability of disease. A risk factor that cannot be reduced or controlled by intervention. Physical inactivity Age Tobacco use Gender Alcohol use Race Unhealthy diets Genetics

13. Gaps In Natural History Absence of a known agent Multifactorial causation Long latent period Indefinite onset 13

14. Prevention Primordial Prevention Primary Prevention Health Promotion Specific Protection Secondary Prevention Early Diagnosis & Treatment Tertiary Prevention Disability Limitation Rehabilitation 14

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16. Prevention Globally Integrated Approach Simultaneous attack on multiple factors “The STEPS NCDs risk factors survey” initiated by WHO WHO Global Action Plan for the Prevention and Control of NCDs (2013-2020) 25% relative reduction in premature mortality from NCDs 2030 Agenda for Sustainable Development (SDGs) 16

17. Common NCDs Cardio-vascular diseases Coronary Heart Disease Hypertension Stroke Chronic Respiratory Diseases (Occupational) Rheumatic Heart Disease Cancer Diabetes Mellitus Obesity Blindness Accidents & injuries 17

18. Coronary Heart Disease (Ischaemic Heart Disease) It is the impairment of heart function due to inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation to the heart. Modern Epidemic 18

19. Coronary Heart Diseases Angina Pectoris Myocardial infarction Irregularities of the Heart Cardiac Failure Sudden Death 19

20. Disease Burden of CHD In 1990 , 29% of all deaths were due to Cardiovascular Diseases globally. In 2012, 31% of all deaths are due to CHD In 2020 , it is expected to reach more than 36% of all deaths. It is likely become most common cause of death worldwide. 86 percent of the global burden of CVD are in the developing countries In Pakistan 12% of all deaths annually, are caused by CHD (National Health Survey, 1990-1994) 200,000 per year that is 410/100,000 of the population. (Recent survey) Mostly in urban than rural 20

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22. Measurement of Burden Loss of life expectancy Proportional mortality ratio CHD incidence rate Age specific death rate Prevalence rate Case fatality rate Measurement of risk factor level Medical care 22

23. Coronary Heart Disease Risk Factors Modifiable risk factors Non-modifiable risk factors 23

24. Coronary Heart Disease Risk Factors Non-Modifiable Age Sex Family History Genetic Factors Personality Type Previous cardio-vascular events Modifiable Tobacco smoking Hypertension Hypercholesterolemia Diabetes Mellitus Obesity Life Style(diet & physical activity) Stress Oral Contraceptives Hormones 24

25. Risk Factors 25

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27. Emerging Cardiovascular Risk Factors Low Estrogen Level Homocysteine Plasma Fibrinogen C-reactive Protein Chlamydia Pneumonia Infection 27

28. Prevention of CHD Primary Prevention Population Strategy Prevention in whole population Specific Interventions Dietary Changes Smoking Blood Pressure Physical Activity Primordial Prevention in whole population 28

29. Prevention of CHD (contd.) Primary Prevention (contd.) High Risk Strategy Identifying the Risk Specific Advise Secondary Prevention Tertiary Prevention PRIMARY PREVENTION REQUIRED EVEN AFTER SECONDARY & TERTIARY PREVENTION 29

30. A 45 year old over weight male presents to the OPD with shortness of breath and chest pain. What is your next line of action? 30

31. Takeaway message NCDs are the leading cause of morbidity and mortality globally. 31

32. Thank you 32