Mention some risk factors for Heart disease & Diabetes Mellitus. What could
be done to reduce complication and maintain long life in such patients.
Ans :
Coronary heart disease—often simply called heart disease—is the main form of heart disease. It is a disorder of the blood vessels of the heart that can lead to heart attack. A heart attack happens when an artery becomes blocked, preventing oxygen and nutrients from getting to the heart. Heart disease is one of several cardiovascular diseases, which are diseases of the heart and blood vessel system. Other cardiovascular diseases include stroke, high blood pressure, angina (chest pain), and rheumatic heart disease.
Risk factors for Heart disease
Risk factors are conditions or habits that make a person more likely to develop a disease. They can also increase the chances that an existing disease will get worse. Important risk factors for heart disease that you can do something about are:
- High blood pressure
- High blood cholesterol
- Diabetes and prediabetes
- Smoking
- Being overweight or obese
- Being physically inactive
- Having a family history of early heart disease
- Having a history of preeclampsia during pregnancy
- Unhealthy diet
- Age (55 or older for women)
Some risk factors, such as age and family history of early heart disease, can’t be changed. For women, age becomes a risk factor at 55. After menopause, women are more apt to get heart disease, in part because their body’s production of estrogen drops. Women who have gone through early menopause, either naturally or because they have had a hysterectomy, are twice as likely to develop heart disease as women of the same age who have not yet gone through menopause.
Another reason for the increasing risk is that middle age is a time when women tend to develop risk factors for heart disease. Family history of early heart disease is another risk factor that can’t be changed. If your father or brother had a heart attack before age 55, or if your mother or sister had one before age 65, you are more likely to get heart disease yourself. Preeclampsia is another heart disease risk factor that you can’t control. However, if you’ve had the condition, you should take extra care to try and control other heart disease risk factors.
Risk factors for Diabetes Mellitus
Risk factors for diabetes depend on the type of diabetes.
Risk factors for type 1 diabetes
Although the exact cause of type 1 diabetes is unknown, factors that may signal an increased risk include:
Family history: Risk increases if a parent or sibling has type 1 diabetes.
Environmental factors: Circumstances such as exposure to a viral illness likely play some role in type 1 diabetes.
The presence of damaging immune system cells (autoantibodies):
Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes autoantibodies. If you have these autoantibodies, you have an increased risk of developing type 1 diabetes. But not everyone who has these autoantibodies develops diabetes.
Dietary factors: These include low vitamin D consumption, early exposure to cow’s milk or cow’s milk formula, and exposure to cereals before 4 months of age. None of these factors has been shown to directly cause type 1 diabetes.
Geography : Certain countries, such as Finland and Sweden, have higher rates of type 1 diabetes.
Risk factors for pre diabetes and type 2 diabetes
Researchers don’t fully understand why some people develop pre diabetes and type 2 diabetes and others don’t. It’s clear that certain factors increase the risk, however, including:
- Weight :The more fatty tissue you have, the more resistant your cells become to insulin.
- Inactivity :The less active the greater Physical activity helps to control weight, uses up glucose as energy and makes body’s cells more sensitive to insulin.
- Family history:Risk increases if a parent or sibling has type 2 diabetes.
- Race:Although it’s unclear why, people of certain races — including blacks, Hispanics, American Indians and Asian-Americans — are at higher risk.
- Age : Risk increases as people get older. This may be because exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes is also increasing dramatically among children, adolescents and younger adults.
- Gestational diabetes: gestational diabetes develop when patients were pregnant, risk of developing pre diabetes and type 2 diabetes later increases. If gave birth to a baby weighing more than 9 pounds (4 kilograms), also at risk of type 2 diabetes.
- Polycystic ovary syndrome :For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
- High blood pressure :Having blood pressure over 140/90 millimeters of mercury (mm Hg) is linked to an increased risk of type 2 diabetes.
- Abnormal cholesterol and triglyceride levels :If have low levels of high-density lipoprotein (HDL), or “good,” cholesterol, risk of type 2 diabetes is higher. Triglycerides are another type of fat carried in the blood. People with high levels of triglycerides have an increased risk of type 2 diabetes. Doctor can let you know what your cholesterol and triglyceride levels are.
Risk factors for gestational diabetes
Any pregnant woman can develop gestational diabetes, but some women are at greater risk than are others. Risk factors for gestational diabetes include:
- Age :Women older than age 25 are at increased risk.
- Family or personal history : Risk increases if people have pre diabetes — a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. Its also at greater risk if there had gestational diabetes during a previous pregnancy, if delivered a very large baby or if had an unexplained stillbirth.
- Weight :Being overweight before pregnancy increases your risk.
- Race :For reasons that aren’t clear, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.
Long life for heart disease patient :
A heart disease patient can led a long life by following the step as bellow :
Lifestyle changes and medicines can help control CHD. Lifestyle changes include following a healthy diet, being physically active, maintaining a healthy weight, quitting smoking, and managing stress.
Heart-Healthy Lifestyle Changes
Heart-healthy lifestyle changes include:
Doctor may recommend heart-healthy eating, which should include:
* Fat-free or low-fat dairy products, such as fat-free milk
* Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
* Fruits, such as apples, bananas, oranges, pears, and prunes
* Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
* Vegetables, such as broccoli, cabbage, and carrots
* Whole grains, such as oatmeal, brown rice, and corn tortillas
When following a heart-healthy diet, Patient should avoid eating:
* A lot of red meat
* Palm and coconut oils
* Sugary foods and beverages
Two nutrients in patient’s diet make blood cholesterol levels rise:
* Saturated fat—found mostly in foods that come from animals
* Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats.
Patient should avoid this type of food.
Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease.
Managing Stress
Research shows that the most commonly reported “trigger” for a heart attack is an emotionally upsetting event—particularly one involving anger. Also, some of the ways people cope with stress—such as drinking, smoking, or overeating—aren’t healthy.
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:
* A stress management program
* Meditation
* Physical activity
* Relaxation therapy
* Talking things out with friends or family
Physical Activity
Routine physical activity can lower many coronary heart disease risk factors, including LDL (“bad”) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the “good” cholesterol that helps prevent coronary heart disease.
Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week, or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.
Smoking can raise the risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with doctor about programs and products that can help to quit smoking. Also, try to avoid secondhand smoke.
Medicines
Sometimes lifestyle changes aren’t enough to control blood cholesterol levels. Sometime may need statin medications to control or lower cholesterol. By lowering cholesterol level, can decrease Patient’s chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have:
* Coronary heart disease, peripheral artery disease, or had a stroke
* Diabetes
* High LDL cholesterol levels
Doctors may discuss beginning statin treatment with those who have an elevated risk for developing heart disease or having a stroke.
Doctor also may prescribe other medications to:
* Decrease your chance of having a heart attack or dying suddenly.
* Lower your blood pressure.
* Prevent blood clots, which can lead to heart attack or stroke.
* Prevent or delay the need for a stent or percutaneous coronary
intervention (PCI) or surgery, such as coronary artery bypass grafting (CABG).
To reduce heart’s workload and relieve coronary heart disease symptoms take all medicines regularly, as doctor prescribes. Don’t change the amount of medicine or skip a dose unless doctor tells to. Patient should still follow a heart healthy lifestyle, even if patient take medicines to treat coronary heart disease.
Medical Procedures and Surgery
Patient may need a procedure or surgery to treat coronary heart disease. Both PCI and CABG are used to treat blocked coronary arteries.
Cardiac Rehabilitation
- Your doctor may prescribe cardiac rehabilitation (rehab) for angina or after CABG, angioplasty, or a heart attack. Nearly everyone who has coronary heart disease can benefit from cardiac rehab. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems.
The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.
Rehab has two parts:
* Education, counseling, and training. This part of rehab helps you understand your heart condition and find ways to reduce your risk for future heart problems. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and how to deal with your fears about the future.
* Exercise training. This part helps you learn how to exercise safely, strengthen your muscles, and improve your stamina. Your exercise plan will be based on your personal abilities, needs, and interests.
Long life for Diabetes Mellitus patient :
Diabetes is a serious disease. Diabetes treatment plan takes round-the-clock commitment. But the efforts are worthwhile. Careful diabetes care can reduce the risk of serious — even life-threatening — complications.
Here are 10 ways to take an active role in diabetes care and enjoy a healthier future.
1. Make a commitment to managing the diabetes
Members of diabetes care team — doctor or primary care provider, diabetes nurse educator, and dietitian can help the patient learn the basics of diabetes care and offer support along the way. But it’s up to the patient to manage the condition.
Learn all about diabetes. Make healthy eating and physical activity part of daily routine. Maintain a healthy weight. Monitor blood sugar level, and follow the doctor’s instructions for managing blood sugar level. Ask diabetes treatment team for help when need .
2. Don’t smoke
Smoking increases the risk of various diabetes complications, including:
* Reduced blood flow in the legs and feet, which can lead to infections, ulcers and possible removal of a body part by surgery (amputation)
* possible removal of a body part by surgery (amputation
* Heart disease
* Stroke
* Eye disease, which can lead to blindness
* Nerve damage
* Kidney disease
3. Keep blood pressure and cholesterol under control
- Like diabetes, high blood pressure can damage blood vessels. High cholesterol is a concern, too, since the damage is often worse and more rapid when have diabetes. When these conditions team up, they can lead to a heart attack, stroke or other life-threatening conditions.
Eating a healthy, reduced-fat diet and exercising regularly can go a long way toward controlling high blood pressure and cholesterol. doctor may also recommend taking prescription medication.
4. Schedule regular physicals and eye exams
Schedule two to three diabetes checkups a year, in addition to yearly physical and routine eye exams.
Eye care specialist will check for signs of retinal damage, cataracts and glaucoma.
5. Keep vaccines up to date
High blood sugar can weaken immune system, which makes routine vaccines more important than ever. Ask doctor about:
Flu vaccine. A yearly flu vaccine can help stay healthy during flu season as well
as prevent serious complications from the flu.
Pneumonia vaccine. Sometimes the pneumonia vaccine requires only one shot. If have diabetes complications or age 65 or older, Patient may need a five-year booster shot.
Hepatitis B vaccine. The Centers for Disease Control and Prevention recommends the hepatitis B vaccine for adults with diabetes who haven’t previously received the vaccine and are younger than 60. If you’re age 60 or older and have never received the hepatitis B vaccine.
6. Take care of teeth
Diabetes may leave prone to gum infections. Brush teeth at least twice a day, floss teeth once a day and schedule dental exams at least twice a year. Call dentist if
gums bleed or look red or swollen.
7. Pay attention to feet
High blood sugar can reduce blood flow and damage the nerves in feet. Left untreated, cuts and blisters can lead to serious infections. Diabetes can lead to pain, tingling or loss of sensation in your feet.
To prevent foot problems:
* Wash feet daily in lukewarm water. Avoid soaking feet, as this can lead to dry skin.
* Dry feet gently, especially between the toes.
* Moisturize feet and ankles with lotion or petroleum jelly. Should not put oils or creams
between toes — the extra moisture can lead to infection.
* Check feet daily for calluses, blisters, sores, redness or swelling.
8. Consider a daily aspirin
Taking a low dose of aspirin every day may reduce risk of heart attack and stroke.
9. Drink alcohol responsibly
Alcohol can cause high or low blood sugar, depending on how much drink and whether eat at the same time. If choose to drink, do so only in moderation and always with a meal.
10. Take stress seriously
If stressed, it’s easy to neglect usual diabetes care routine. The hormones in body may produce in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. To take control, set limits. Prioritize your tasks. Learn relaxation techniques. Get plenty of sleep.
Above all, stay positive. Diabetes care is within control. If patient willing to do
diabetes won’t stand in the way of an active, healthy life.
Wrtitten by Fahana Newaz, ASIAN UNIVERSITY, MALASIA
