GRON3211 Chronic Disease Management in Ageing Past Paper - Week 1 - 02 Sept 2024 PDF

GRON3211 Chronic Disease Management in Ageing Week 1 02 Sept 2024 Hypertension, blood lipid disorders and diabetes mellitus Mr. CP Chiu (Photo credit: Esquire HK) Content 1. Chronic diseases 2. What we speak????? 3. What w...

GRON3211 Chronic Disease Management in Ageing Week 1 02 Sept 2024 Hypertension, blood lipid disorders and diabetes mellitus Mr. CP Chiu (Photo credit: Esquire HK) Content 1. Chronic diseases 2. What we speak????? 3. What we think????? 4. Blood pressure and Hypertension (HT) 5. Lipid profile and Lipid Disorders 6. Blood sugar and Diabetes Mellitus (DM) 7. Chronic Disease Co-Care (CDCC) Pilot Scheme / 慢病共治先導計劃 1. Chronic diseases What is chronic disease? Chronic diseases and acute diseases??? 1. Chronic diseases Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of a genetic, physiological, environmental and behavioural factors. (WHO, 2023) (DH, 2009) 1. Chronic diseases The risk of noncommunicable diseases accumulates with age and is influenced by factors acting at all stages of the life span. 1. Fetal Life Fetal growth, maternal nutritional status, socioeconomic position at birth. 2 Infancy and Childhood Growth rate, breastfeeding, infectious diseases, unhealthy diet, lack of physical activity, obesity, socioeconomic position. (DH, 2008) 3. Adolescence Unhealthy diet, lack of physical activity, obesity, tobacco and NCDs share FOUR major risk factors: alcohol use. 1. Unhealthy diets 2. Physical inactivity 4. Adult life 3. Tobacco use Adult behavioural and biological risk factors. (Aboderin et al., 2002) 4. The harmful use of alcohol  1. Chronic diseases Global situation: NCDs kill 41 million people each year, equivalent to 74% of all deaths globally. The main types of NCD are : 1. Cardiovascular diseases (e.g. heart attacks and stroke) (17.9 million); 2. Cancers (9.3 million); 3. Chronic respiratory diseases (e.g. chronic obstructive pulmonary disease) (4.1 million) and; 4. Diabetes (2.0 million including kidney disease deaths caused by diabetes) These four groups of diseases account for over 80% (33.3M/41M) of all premature NCD deaths. (WHO, 2023) 1. Chronic diseases Week 12 Week 2 Week 3 Week 4 Week 1 (DH, 2022)  1. Chronic diseases Hypertension (HT), Lipid Disorders & Diabetes Mellitus (DM) ??? Why we have today’s topic????? Poorly controlled hypertension may lead to heart failure, coronary heart disease, stroke and kidney failure. Excess cholesterol may be deposited on the inner wall of blood vessels, leading to the narrowing or blockage of the lumens. Condition: Ischemia 缺血 When happens in the heart: Coronary heart diseases (Week 2 lecture); When happens in the brain: Stroke (Week 4 lecture) Poorly controlled blood glucose levels may lead to vascular damages and lead to diseases in various systems and organs (e.g cardiovascular, retina, kidneys and nerves). Therefore, DM is the leading cause of cardiovascular diseases, stroke, blindness, kidney failure and lower limbs ulcers. (Health Bureau, 2022) (Photo credit: Our Hong Kong Foundation) 2. What we speak????? Alien Talk nephropathy neuropathy (Photo credit: William X. Adams, Amazon.com) 2. What we speak????? Prefixes and suffixes (Nelson & Greene, 2021) Prefixes are placed at the beginning of words. Body part prefixes Common prefixes Prefix Meaning Example Prefix Meaning Example Arterio- Artery Arteriole Hemi- Half Hemiplegia Cardio- Heart Cardiology Quadri- Four Quadriceps Cerebro- Brain Cerebrovascular Gluco- / Glyco- Glucose, sugar Glucose accident (CVA) = Stroke Coron- Heart Coronary arteries Lip- / Lipo- Fat Lipid Nephro- Kidney Diabetic nephropathy Sclero- Renal- Renal disease Neuro- Nerve Diabetic neuropathy A- / An- Without; Lacking Anaemia Retino- Retina of the eye Diabetic retinopathy Hypo- Under; Deficit Hypotension Hypoglycemia Vasculo- Blood vessel Vasculitis Hyper- Above, beyond Hypertension Hyperglycemia 2. What we speak????? Prefixes and suffixes Suffixes are placed at the end of words. Common Suffixes Suffix Meaning Example -emia Blood condition Hypoglycemia Hyperglycemia Anaemia -itis Inflammation Bronchitis -pathy Diseases Neuropathy Retinopathy -plegia Paralysis Hemiplegia Quadriplegia -sclerosis Hardness Arteriosclerosis Atherosclerosis (Nelson & Greene, 2021) 2. What we speak????? Let’s practice Cardiopathy? Hemiplegia? Quadriplegia? Cardiovascular diseases? Cerebrovascular accident (CVA)? Hypoglycemia? Hyperglycemia? Hypertension? Hypotension? Hypercholesterolaemia? (Photo credit: William X. Adams, Amazon.com) 2. What we speak????? Combine the prefixes and suffixes Let’s practice Prefix-1 Meaning Prefix-2 Meaning Suffix Meaning Example Cardio- Heart - - -pathy Diseases Cardiopathy Hemi- Half - - -plegia Paralysis Hemiplegia Quadri- Four Quadriplegia Cardio- Heart Vasculo- Blood vessel Cardiovascular diseases Cerebro- Brain Vasculo- Blood vessel - - Cerebrovascular accident (CVA) Hypo- Under; Gly- Glucose -emia Blood Hypoglycemia Deficit condition Hyper- Above, Gly- Glucose -emia Blood Hyperglycemia beyond condition (Photo credit: Google play) Hyper- Above, lipid Fat -emia Blood Hyperlipidemia beyond condition (Nelson & Greene, 2021) 3. What we think?????? Salutogenesis Pathogenesis Focuses on creation To understand diseases and maintenance of process. good health. Focus on causes of The curative disease and risk factors resources, potential involved in disease for active adaptation generation. to unaccustomed situation and Disease control resource strategies target these development are causes. given much emphasis. (Bauer & Jenny, 2017) (Bhattacharya et al., 2020)  4. Blood pressure & Hypertension (HT) Cardiovascular System 3 components: Heart + Blood vessels + Blood Heart pumps blood Blood vessels transport blood which contains: oxygen/carbon dioxide; nutrients and waste; hormones, and heat. (Nelson & Greene, 2021. From Betts et al., 2013. (Marieb, 2004) Licensed under CC BY 4.0) 4. Blood pressure & Hypertension (HT) Double circulation Pulmonary and Systemic circuits Pulmonary circuit: Transports blood to and from the lungs, where it picks up oxygen and drops off carbon dioxide. Systemic circuit: Transports freshly oxygenated blood to virtually all of the tissues of the body and returns relatively deoxygenated blood and carbon dioxide to the heart to be sent back to the pulmonary circulation. Then, keep circulating. Vein ← venules ← capillaries ← arterioles ← Artery 4. Blood pressure & Hypertension (HT) Blood vessels and blood pressure Arteries: Transport blood away from the heart and branch into small vessels, called arterioles. Blood pressure is the force exerted by blood upon the walls of the artery, it generally refers to the pressure of blood flowing in the arteries of the systemic circulation. (Nelson & Greene, 2021. From Betts et al., 2013. Licensed under CC BY 4.0)  4. Blood pressure & Hypertension (HT) Systolic and Diastolic blood pressure Systolic blood pressure (SBP) is the pressure exerted upon the walls of blood vessels when the heart contracts. Diastolic blood pressure (DBP) is the one when the heart relaxes. BP is measured in millimeters of mercury (mmHg). (Health Bureau, 2022) (Photo credit: Tiger Medical)  4. Blood pressure & Hypertension (HT) Blood pressure level (mmHg) BP categories SBP DBP Recommendations Optimal