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GLOBAL VARIATIONS OF CHRONIC DISEASE

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Chronic diseases all around the world have been causing lots deaths and having devastating effects on families (CDC, 2011). In this essay, I will discuss coronary heart disease symptoms, detection, prevention, causal mechanisms, treatment, and effects. I will also analyze its global variations and recommend how public health officers can be able to promote prevention and treatment measures.

Coronary heart disease is a disease that develops over a long time. This disease involves accumulation or deposition of plaque in the coronary arteries that supply the heart muscles with oxygen and nourishments. The plaque hardens with time and it can burst at time and formation of a clot can occur in the artery causing more narrowing or blockage. In the long run, the accumulation leads to a decrease of the coronary artery diameter. This causes limitation of the oxygen and other nourishments supplied to the heart muscles. This weakens the heart muscles hence impairing the function of the heart resulting to angina, myocardial infarction, heart attack/heart failure and finally death (Krasner & Riegelman, 2013).

A coronary heart disease has several causes or factors that are affiliated to it. These factors are classified into modifiable and non-modifiable depending on whether they can be prevented or not. Some of the modifiable factors are: smoking, high and chronic alcohol use, high levels of cholesterol in the blood, high blood pressure, blood vessel inflammation and high levels of sugar in the blood/diabetes. These factors can be modified by change of health behavior. There several factors that are non-modifiable at all. These include; age, race/ethnicity and genetics. The individual has no control over the factors. Development of coronary heart disease on the affected individual makes them experience several signs and symptoms. The most prevalent symptom of coronary heart disease is angina. This is the pain experienced in the chest, neck, jaw, back or even shoulder as a result of heart muscle failing to receive oxygen. The pain increases with activity/exercise and emotional stress. The other symptom of coronary heart disease is shortness of breath or dyspnea. This results from the inability of the heart to pump oxygenated blood to the rest of the body due to heart muscle compromise (WHO, 2011).

The diagnosis of coronary heart disease comes after the compilation of family and medical histories, physical examination, clinical manifestations and results from tests and procedures. A single test cannot diagnose the disease. The tests that are done include the electrocardiogram. This involves detection and recording of the heart’s activity. This detects how fast the heart is beating and the rhythm of beating. It also records the strength and timing of electrical signal passing through the heart. This identifies the damage of the heart muscle. The other tests are bleed tests that identify the levels of sugars and cholesterol in the blood. Chest X-ray echocardiography are also important. This can determine signs of heart failure like enlargement of the heart.

Coronary heart disease can be treated by addressing the modifiable causes or risk factors. The methods of treatment involve lifestyle changes, use of medications and medical procedures. The Lifestyle changes include eating a healthy diet, increasing physical activity, quitting smoking and drinking and maintaining a healthy weight. These are very crucial as they lower blood sugars and cholesterol. They also prevent the formation of plaque in the coronary arteries hence maintain a healthy heart. Use of medicines is another method. These drugs are applicable when the lifestyle changes are not enough. These drugs act by reducing the workload of the heart, decreasing chances of a heart attack and decreasing the blood sugars, fats, and cholesterol. The medications include anticoagulants also blood thinners; aspirin and anticlotting medicines. Other Medications also include: ACE inhibitors, beta blockers, calcium channel blockers, nitroglycerin and glycoprotein IIb-IIIa (CDC, 2011).

Surgical procedures are also used for severe cases. These include angioplasty and coronary artery bypass grafting. These procedures are aimed to unblock the blocked coronary arteries. A coronary heart disease can be prevented by modifying the risk factors. These involve change of lifestyle to adopt a healthy way of life. This is by eating vegetables, fruits and foods low or without fats and cholesterol. It also involves eating foods low in sodium and sugars. Prevention is also adopting exercising behavior which helps to lower fats and cholesterol in the blood. This is also advised for the old-age as they have a double risk. Besides prevention also includes quitting smoking and use alcohol. With these measures, the occurrence of coronary heart disease can be prevented entirely or delayed. In the US, It is estimated that 16,300,000 people, that is 7% of American adults 20 years and above have coronary heart disease. 8.3% of these are males, and 6.1% are females (WHO, 2011). It is predicted that by the year 2030 another 8,000,000 adults could be diagnosed with coronary heart disease, representing a 16.6% increase in its prevalence from 2010. In the case of coronary heart disease, it is discussed as new cases of a coronary/heart attack emerge. In the year 2011, approximately 785,000 American adults are estimated to have new coronary attacks while 470,000 will experience recurrent heart attacks. It's estimated that the annual incidence of new cases of heart attack is 610,000, with 325,000 recurrent attacks (Krasner & Riegelman, 2013).

The average age of getting a first heart attack is 64 years for men and 70.3 years for women in the US. On the basis of gender and the incidence of coronary heart disease, there are some differences between men and women. It comprises more than half of all cardiovascular activities in people under age 75, with the lifetime risks of developing coronary heart the disease after age 40 being 49% for men and 32% for women. The incidence of coronary heart disease itself is also different for men and women. The incidence of coronary heart disease in women falls by 10 years behind men for total coronary heart disease cases (WHO, 2011).

In India, coronary heart disease prevalence is high as compared to the total population. Coronary heart disease incidence is approximately 35.8 million people in India. Since over 70% of India’s population live in the rural areas, the statistics state that, between 6.5% and 13% of people living in urban areas and between 1.6% and 7.4% of rural dwellers in India are living with a cardiovascular disease, and men and women are affected almost equally. The incidence of coronary heart disease increases yearly in India and younger age is being involved than in the US. It is predicted that by the year 2020 the incidence rates will increase by 120% and 137% for women and men respectively in India (WHO, 2011).

Considering these two countries, USA and India, there are major disparities in the incidence and prevalence rates. One of the reasons to the differences is because the US is a developed country as compared to the developing India. So due to this difference, the US has improved mechanisms in the management and control of coronary heart disease. The population in the US is adopting a change in lifestyle so as a means of reducing the prevalence. The other reason to the disparity is the nutritional differences between the two countries. The changes associated with the nutritional transition in a developing country (India) and a decrease in physical activity due to urbanization is a big reason for the disparity. Finally, most people in India are in the middle or low socio-economic classes as compared to the US where most people are in the upper socio-economic class. Increasing consumption of energy-dense diets high in unhealthy fats, oils, sodium, and sugars has contributed to an increase in coronary heart disease incidence in low and middle-income countries (CDC, 2011).

In conclusion, for the incidences and prevalence of coronary heart disease to unify globally, the risk-factor reduction is the key recommendation. Awareness has to be created worldwide so as the importance of health behavior and lifestyle changes can be adopted globally. The importance of low fat and cholesterol foods should be addressed globally (Snooks, 2009). Physical activity should also be advocated globally. Lifestyle change is the only sure remedy for coronary heart disease thus public health professionals should adhere to educating this to the population so as to stimulate its practice. Smoking and alcohol use should be addressed because they are also risk factors/causes of coronary heart disease globally.

References

Centers for Disease Control and Prevention. (2011). Chronic disease prevention and health promotion. Retrieved from http://www.cdc.gov/chronicdisease/index.htm

Centers for Disease Control and Prevention. (2011). About the journal. Retrieved from http://www.cdc.gov/pcd/about_the_journal/index.htm

Krasner, R., & Riegelman, R. (2013). Human disease and prevention (Laureate Education, Inc., custom ed.). Burlington, MA: Jones & Bartlett Learning

WHO. (2011b). Chronic diseases. Retrieved from http://www.who.int/topics/chronic_diseases/en/

Snooks, M. K. (2009). Applications of health psychology to chronic illness. In Health psychology: Biological, psychological, and sociocultural perspectives (pp. 321–345). Sudbury, MA: Jones and Bartlett.

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