Chronic Disease:

1. Chronic Disease: Common Causes, Simple Strategies

2. Chronic Disease Volunteers will learn basics about common chronic diseases – diabetes, hypertension, and heart disease – including risk factors, prevention, and management. In the Chronic Disease module, trainees will learn: • The chronic disease burden in America • Common risk factors for chronic disease • How to prevent chronic disease • Strategies for chronic disease management

3. What is a chronic disease? A long-lasting condition that can usually be controlled but not cured.

4. Chronic Disease • Leading cause of death and disability in the US. • Accounts for 70% of all deaths in the US.

5. Chronic Diseases • Diabetes • Hypertension • Heart Disease • High Cholesterol • Arthritis • Asthma • Others?

6. Percentage of U.S. Adults, by Number of Chronic Conditions

8. Activity: Chronic Disease Risk Factors

9. Chronic Disease Risk Factors

10. Disease as Risk Factor

11. Know Your Risk • Factors you can change • Factors you can’t change

12. Know Your Risk Excess Stress Alcohol Use Sedentary Lifestyle High Salt Diet Obesity Smoking

13. Hypertension & Stroke

14. High Blood Pressure

16. Hypertension Prevalence by Age

17. What is blood pressure? Blood pressure is the force of blood pressing against the wall of the arteries that carry blood away from the heart.

18. What is blood pressure? Measures of pressure: • Systolic pressure measures the force of blood vessels when the heart contracts • Diastolic pressure measures the force as the heart relaxes

19. What is Hypertension? • High blood pressure • Blood pressure that is persistently higher than recommended • 1 in 3 Americans have high blood pressure

20. Blood Pressure Ranges

22. High Blood Pressure is Harmful • Makes the heart work too hard. • Makes the walls of arteries hard. • Increase risk for heart disease and stroke. • Can cause heart failure, kidney disease, and blindness.

23. Who can develop High Blood Pressure? • Anyone • Most common in: • African-Americans • Older adults • Overweight, family history • High normal blood pressure

24. High Blood Pressure Treatment • Prehypertension – Lifestyle modifications • Hypertension – Lifestyle modifications + medication • Maintain a healthy weight, lose weight if overweight. • Be more physically active. • Drink alcohol in moderation. • Reduce salt and sodium.

25. Limit Sodium • No more than 2,300 mg/day • 1,500 mg/day • Pre-hypertension • Hypertension

27. Heart Disease

29. Cholesterol • Cholesterol is a fat-like substance • Cholesterol will build up on artery walls when too much is in the blood • “Hardening of the arteries” • Arteries narrow, blood flow is blocked

30. Know Your Cholesterol Numbers HDL: 60 or above is good (protective). Below 40 is heart disease risk factor

31. What causes high cholesterol? • Diet • Weight • Physical Activity • Heredity • Age & Gender

32. Heart Disease Risk Factors You Can Control • Smoking • High blood pressure • High cholesterol and high triglycerides • Overweight/obesity • Physical inactivity • Diabetes and pre-diabetes • Metabolic syndrome

33. Risk Factors You Cannot Control • Family history of early heart disease • Age (55 and older for women) • History of preeclampsia during pregnancy

34. Other Risk Factors • Sleep apnea • Stress or depression • Too much alcohol • Birth control pills • Anemia • Unhealthy diet

35. Heart Disease Risk Factors • The Multiplier Effect • 1 risk factor = double risk • 2 risk factors = 4x risk • 3 or more risk factors = up to 10x risk By doing just 4 things – eating right, being physically active, not smoking, and keeping a healthy weight – you can lower your risk of heart disease by as much as 82%!

36. You Can Lower Heart Disease Risk • Follow a healthy eating plan • Low in saturated fat, trans fat, and cholesterol; moderate in total fat • Limit salt and sodium • Limit alcoholic beverages • Whole grains, fruits, and vegetables • Fish, poultry, and lean cuts of meat • Nonfat or low-fat milk, cheeses, and yogurt • Maintain a healthy weight

37. You Can Lower Heart Disease Risk • Manage diabetes, high blood pressure, and high blood cholesterol through living a healthy lifestyle • Take medication, if prescribed

38. Diabetes

39. What is diabetes?

40. Know Your Blood Sugar Numbers • Normal blood sugar • 70 to 100 mg/dl (fasting) • “Borderline” diabetes = Pre-diabetes • 100 to 125 mg/dl (fasting) • Diabetes • 126 mg/dl or higher on two separate readings

41. Diabetes

42. Diabetes carries serious health risks

43. Type 2 Diabetes Risk Factors • Overweight or obese • Age 45 or older • Family history of diabetes • Certain racial/ethnic groups • High blood pressure • Low HDL or high triglycerides • History of gestational diabetes • Physically inactive • History of heart disease or stroke • Depression

44. Diabetes Prevention • Diabetes can be prevented or delayed! • Lose 5 - 7% of body weight • Healthy food choices • Regular exercise

45. Diabetes Symptoms • Urinating often • Feeling very thirsty • Feeling very hungry • Extreme fatigue • Blurry vision • Cuts/bruises slow to heal • Tingling, pain or numbness in hands/feet

46. Preventing Chronic Disease General Tips

47. Prevention • Lifestyle modifications include: • Maintaining a healthy weight • Increase physical activity • Smoking cessation • Limit alcohol consumption • Limit fat intake • Control diabetes • Stress relieving techniques • Reduce salt/sodium intake

48. Health is affected more by what we do than what we know.

49. Chronic Disease & the Social Ecological Model

50. Well Connected Communities is a nationwide effort to cultivate wellness led by America’s Cooperative Extension System, in partnership with National 4-H Council, with support from the Robert Wood Johnson Foundation.