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Disease Management: Know Your Risks

Thanks in part to technology and continuing medical research the world’s industrial populations continue to live longer.

Unfortunately living longer is not analogous to living healthier or indicative of our body’s ability to fight disease. The Centers for Disease Control and Prevention released a report this summer announcing the increased prevalence of multiple chronic conditions among adults 45 years of age and older.

The National Health Interview Survey, which contacted around 30,000 individuals between 1999 and 2000 and approximately the same number of people in 2009 and 2010, reported on the incidence of nine chronic, self-reported conditions: hypertension, heart disease, diabetes, cancer, stroke, chronic bronchitis, emphysema, current asthma and kidney disease. During the 10-year period, the percentage of adults with two or more of the selected chronic conditions increased irrespective of gender, race, ethnicity and most income groups. While each condition has its own prescribed treatment, these findings suggest challenges for medical professional in the near future as they educate patients on managing multiple chronic conditions and provide the appropriate treatment, as well as predict future health care needs.

The three most common combinations of conditions in both adults between the ages of 45 and 64 and those 65 years and older were hypertension and diabetes, hypertension and heart disease and hypertension and cancer:

At least half of all those who reported the three common combinations also indicated they were diagnosed with at least one other of the nine conditions.

Hypertension, or high blood pressure, may be the result of several different factors, including:

    • High sodium intake
    • Kidney, nervous system or blood vessel conditions
    • Hormonal levels in the body
    • Age
    • Ethnicity
    • Obesity
    • Frequent stress or anxiety
    • Excessive alcohol use
    • Family history of hypertension
    • Diabetes diagnosis
    • Smoking
    • Some medications1

Depending on the cause, the U.S. National Library of Medicine describes the condition as controllable based on medical and lifestyle changes; however, in many cases no direct causal link may be found for hypertension.

Regardless of the documented cause, living a healthy lifestyle by exercising and eating a nutrient-rich diet can make a significant difference not only with the management of hypertension, but managing or preventing multiple chronic conditions in our population. Medical research suggests that cancer survivors, like all members of the population, benefit from weight management, a healthy diet, regular exercise and smoking cessation. In addition, conditions like heart disease can be brought on by poor health habits, such as obesity or high cholesterol. Treatment for hypertension reads like every “live healthier” refrain: eat a heart-healthy diet with plenty of potassium, fiber and water; regular exercise; quit smoking; limit alcohol and sodium intake; reduce your stress levels.

The prevalence of multiple chronic conditions in the populations aged 45 years and older has implications for the future of health care, both in financing and treatment. Encouraging individuals to take an active role in their own health, whether through wellness in the workplace, smoking cessation or investing in executive physicals are great first steps to addressing these future concerns.

Written by Jim Lindberg, M.D., Hoag Executive Health Chief of Service

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[1] http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/