Chronic diseases – A partner for the rest of your life

The lives of far too many people in the world are being blighted and cut short by chronic diseases.

Chronic diseases are long-lasting conditions that can be controlled but not cured.

Chronic diseases persist for a long time, generally cannot be prevented by vaccines or cured by medication, nor do they just disappear. They tend to become more common with age.

Major cause of death
The World Health Organisation (WHO) states that chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality in the world. Globally in 2005, of approximately 58 million deaths, 35 million were a result of chronic diseases, representing 60% of all deaths. They were then the major cause of death among adults in almost all countries and the toll was projected to increase by a further 17% within the next 10 years… which is NOW.

Out of the 35 million people who died from chronic disease in 2005, half were under 70 years of age and half were women.

According to the WHO, this invisible epidemic is an under-appreciated cause of poverty and hinders the economic development of many countries. Contrary to common perception, 80% of chronic disease deaths occur in low and middle-income countries.

Data from the WHO shows that chronic disease is also the major cause of premature death around the world even in places where infectious diseases are rampant.
Overweight and obese children have been increasing worldwide and the incidence of type 2 diabetes is growing enormously.
This is a very serious situation, both for public health and for the societies and economies affected. Until recently the impact and profile of chronic disease has generally been insufficiently appreciated.

Need for action
The actual scale and severity of the problem and the urgent need for action is very clear and the means of preventing and controlling most chronic diseases are already well established.

Chronic illness affects the population worldwide. Although chronic diseases are among the most common and costly health problems, they are also among the most preventable and most can be effectively controlled.

It is vital that countries review and implement the necessary interventions, taking a comprehensive and integrated public health approach, as the cost of inaction is clear and unacceptable. Through investing in vigorous and well-targeted prevention and control, there is now a real opportunity to make significant progress and improve the lives of populations across the globe.

Do we, the lucky, privileged individuals still having “some” financial capacity, living in developed (or developing) countries, need to wait for governments to implement prevention regulations? Not really. We can do a lot for our own health and those of others around us by preventing chronic diseases. Many of the important actions are free if we just put life priorities within proper dimensions.

In medicine, the opposite of “chronic” is “acute”. A chronic course is further distinguished from a recurrent course; recurrent diseases relapse repeatedly, with periods of remission in between.

Chronic diseases are of long duration and generally slow progression.

The four main types of chronic non-communicable diseases are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes. There are other chronic long-lasting medical conditions, such as HIV/AIDS and Hepatitis C that are caused by transmissible infections.

Risk factors
While risks vary with age and gender, most of the common chronic diseases are caused by dietary, lifestyle and metabolic risk factors that are also responsible for the resulting mortality – therefore these conditions may be prevented by behavioural changes. Not using the preventive services necessary to detect conditions at an early stage, delay in receiving care and non-compliance and continuity in treatment result in worse outcomes for patients.

Overuse of antibiotics has recently been shown to be associated with chronic diseases, for example, chronic liver diseases.

What can we individually do?
Many chronic diseases are preventable or react more favourably in terms of management and medical treatment in those persons who adopt healthy behaviours, such as controlling body weight, eating nutritious foods, avoiding tobacco and increasing physical activity.

Get adequate help from healthcare providers to:
▪ Promote healthy living (better diet, more physical activity and tobacco cessation) and healthy societies
▪ Prevent premature deaths and avoid unnecessary disability due to chronic diseases. The solutions exist now, and many are simple, cheap and cost effective
▪ Treat chronic diseases effectively, using latest available knowledge.
▪ Care for yourself and your family by providing appropriate good quality healthcare for major chronic diseases.

When living with a chronic illness it is important to learn how to deal with the fact that you have a new partner for life and the relevant fact is that it is necessary to take the best possible options to extend life to the longest possible period of time, with the best quality possible.

A patient with a chronic disease has to get used to a new “normal”.

Best health wishes,
Dr. Maria Alice

By Dr Maria Alice
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Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service / Medilagos. Medical Director – Grupo Hospital Particular do Algarve