preventing the big 3

PREVENTING THE BIG 3HYPERTENSION,

DIABETES, CHOLESTEROL

Dolores Van Bourgondien, ANP-BC, RN,MSN, BA, MA

October 2nd, 2013

Hypertension, Diabetes, Cholesterol

• Facts• Hypertension• Diabetes• Cholesterol• Prevention

Facts

Hypertension

Hypertension Facts• 31.9 Percent of adults ages 20 and over with hypertension 1 in 3• 38.9 Million - Number of visits to physician offices with hypertension as

primary diagnosis: Source: • 3.6 Million - Number of visits to hospital outpatient departments with

hypertension as primary diagnosis• More than 348,000 American deaths in 2009 included high blood

pressure as a primary or contributing cause• 69% of people who have a first heart attack, 77% of people who have a

first stroke, and 74% of people with chronic heart failure have high blood pressure.3 High blood pressure is also a major risk factor for kidney disease.

• High blood pressure costs the nation $47.5 billion annually in direct medical expenses and $3.5 billion each year in lost productivity.

•

Hypertension FactsAbout half (47%) of people with high blood pressure have their condition under controlAlmost 30% of American adults have prehypertension—blood pressure numbers that are higher than normal, but not yet in the high blood pressure range.3 Prehypertension raises your risk of developing high blood pressure.Reducing average population sodium intake from 3,300 mg to 2,300 mg per day may reduce cases of high blood pressure by 11 million and save 18 billion health care dollars annually.5

Hypertension Facts

Diabetes

Diabetes Facts• 25.8 million Americans have diabetes — 8.3 percent of the U.S.

population. Of these, 7 million do not know they have the disease.• In 2010, about 1.9 million people ages 20 or older were diagnosed

with diabetes.• The number of people diagnosed with diabetes has risen from 1.5

million in 1958 to 18.8 million in 2010, an increase of epidemic proportions.

• It is estimated that 79 million adults aged 20 and older have prediabetes. Prediabetes is a condition where blood glucose levels are higher than normal but not high enough to be called diabetes. Studies have shown that by losing weight and increasing physical activity people can prevent or delay prediabetes from progressing to diabetes.

Diabetes Facts• Type 1 - (previously called insulin-dependent or juvenile-

onset) diabetes accounts for approximately 5 percent of all diagnosed cases of diabetes in adults.

• Type 2 - (previously called non-insulin-dependent or adult-onset) diabetes accounts for 90 to 95 percent of all diagnosed cases of diabetes in adults. Type 2 diabetes is increasingly being diagnosed in children and adolescents.

• Gestational - occurs in 2 to 10 percent of pregnancies. Women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes, mostly type 2, in the next 10 to 20 years.

Diabetes Facts• Diabetes is the seventh leading cause of death listed on

U.S. death certificates.• Cardiovascular disease is the leading cause of death

among people with diabetes — about 68 percent die of heart disease or stroke.

• The overall risk for death among people with diabetes is about double that of people without diabetes.

• Total health care and related costs for the treatment of diabetes run about $174 billion annually.

• Of this total, direct medical costs (e.g., hospitalizations, medical care, treatment supplies) account for about $116 billion.

• The other $58 billion covers indirect costs such as disability payments, time lost from work, and premature death..

Diabetes Facts

Cholesterol

Cholesterol Facts

• 71 million American adults (33.5%) have high LDL, or “bad,” cholesterol

• Only 1 out of every 3 adults with high LDL cholesterol has the condition under control

• Less than half of adults with high LDL cholesterol get treatment

• People with high total cholesterol have approximately twice the risk of heart disease as people with optimal levels. A desirable level is lower than 200 mg/dL.

• The average total cholesterol level for adult Americans is about 200 mg/dL, which is borderline high risk.2

Cholesterol Facts• The percentage of American adults with high total

cholesterol has decreased from 18.3% to 13.4%.• The percentage of American adults with high LDL

cholesterol has remained around 34% over the past decade, but treatment of high LDL cholesterol has increased from 28.4% in 1999–2002 to 48.1% in 2005–2008.1

• Cholesterol Check once every 5 Years• During 2009–2010, 68% of Americans age 20 and over

reported that they had their cholesterol checked within the previous five years. Less than half (49.7%) of Hispanic men were screened for high cholesterol in the previous five years.

• In 2009, 96 million visits to doctors' offices (9.2% of all visits) included a cholesterol test

Cholesterol Facts – Know your numbers

Cholesterol Facts – Know your Food

• Shellfish• Processed Foods• Animal Products• Egg Yolk• Caviar• Butter• Cheese

Metabolic Syndrome

What is Metabolic Syndrome• Cluster of Symptoms that raise your risk for heart disease and

other health problems• Waist Circumference greater than 35 Inches in females 41 Inches

in Male• Obesity – BMI greater than 31 • Apple Shaped• Abdominal Fat• Elevated triglycerides• Low LDL• Hypertension• High Blood Sugar

What is Metabolic Syndrome

PREVENTION

Prevention

• Therapeutic Lifestyle Changes

• Eat Right• Exercise• Weight Loss• Stress Reduction• Sleep Well

Prevention

• Eat Right• Fruits• Vegetables• Low Fat• Decrease animal fats• Whole Grain• High Fiber

Prevention

• Exercise• 150 Minutes per week• 20+ Minutes per day• Mix of Cardio and

Strength• Promotes weight loss• Decreases Stress

Prevention

• Weight Loss• Reduces risk for heart

disease• Reduces risk for

Diabetes

Prevention

• Stress Reduction• Exercise helps shed

weight• Meditation decreases

cortisol levels

Prevention

• Sleep

Take home points

• Prevention is better than cure• America's health care system is in crisis

precisely because we systematically neglect wellness and prevention.

• Prevention is one of the few known ways to reduce demand for health and aged care services.

• Diet, exercise, are known to prevent

QUESTIONS?

APPENDIX