Major Killer Diseases of the World.

Thousands of people die from diseases which are preventable and curable. This needless waste of human life is both sad and difficult to understand given the fact that the economic growth has tripled in the last two decades.

Figure 1: Ischemic Heart Disease is the number one killer globally.

The number one killer, globally, is ischemic heart disease. The good news is that it is being defeated. Many patients with heart attacks are surviving to tell their story, the frequency of heart attacks is on a downward trend, and society is “listening” to research by consuming less cholesterol. The consumption of cigarettes , in western countries is down but is increasing in developing economies. More and more individuals get annual check ups and do exercise regularly. Statistics show that life expectancy is increasing too. An examination of figures published by the world health organization (2003) show that more than seven million people die of Ischemic heart disease, in the US alone close to one million people die prematurely of heart diseases. This is shown in table 2 (below).

Table 1. All countries Causes of Total deaths

Source: The World Health Report, 2003, The World Health Organization (WHO)

The second major killer is ischaemic diseases of the brain. This is again related and partially caused by hypertension, high cholesterol, cigerattes and reduced exercise. It is hoped that with improved management of blood cholesterol the frequency of CVAs will decrease and there will be a corresponding increase in life expectancy.

The other major killers are chronic respiratory diseases, cancers, HIV and TB. The incidence of HIV is rising in developing economies, so is the survival period after infection. This is mainly due to the fact that newer treatment strategies are working and the new anti-viral medications are more effective. However, the development of an effective vaccination program is still not in sight. This could be due to the fact that people with aids have not been able to organize themselves effectively. This is not surprising because they do not live long to be able to develop an effective network before they die.

Table 3 shows the mortality figures for Australia. The major killers are the same. The problem with Australian figures is that they are not broken down by economic status. If this was done the figures would show that Indigenous people suffer from third world country conditions. A fair amount is being done but the political courage is lacking in the present political administration. (This is a personal view).

Table 2. Leading Causes of Death U.S., 2002

Source: U.S. National Center for Health Statistics, Health, United States, 2004.

It is well known that the major killer is cardio and cerebrovascular disease of the blood vessels of the brain and the heart. What is not clearly understood is the lack of human motivation to defeat these two diseases. The occurrence of both of these diseases can be impacted significantly by a few relatively simple interventions.

Table 3 Australia: Causes of Death 2002

Source: Death and DALY estimates by cause, 2002

The question I am tempted to ask is who is paying the price for the lack of political leadership. The answer, based on economic research, is that families are the big looser. Families, loose because the money which was supposed to come as retirement income just dies with the breadwinner. As a nurse who worked in ER for 15 years it is my observation (subjective) that many people die soon after they retire. Statistics show that it is better to continue to work to live long. People who continue to work live longer. It is probably related to them remaining active and to them having a better sense of subjective wellbeing.

Picture 1: Angiograms of Cerebral Artery showing Cerebral Ischaemia.

The angiograms of the coronary artery and the cerebral blood vessels show that arterial occlusion is a major problem. As stated earlier, the conditions are preventable, treatable. Early interventions are necessary, when I say early, I mean real early, as early as primary or preschool level.

Current research shows that the most likely age of onset of a heart attack is over 55. However, I have seen patients as young as 25 suffering a heart attack. Maybe, the study of these patients will tell us why heart attack occur in the first place?

Individuals who suffer from Diabetes Mellitus suffer from heart attacks more frequently and at an earlier age.

Elevated levels of certain amino acids and proteins (e.g., homocysteine, C-reactive protein, fibrinogen) also increase the probability of an early heart attack.

It is known that men are more likely to suffer from heart attacks than women. Also they suffer from heart attacks earlier.

Certain Heredity characteristics predispose some people to heart attacks. The genome project has not finished charting all the genetics which contribute to heart attacks.

High blood pressure, also known as hypertension, is a precursor to coronary artery disease and cerebral vascular diseases.

High fat diet which usually consists of beef drippings, pork, red meats is a major killer of human beings.

High levels of "bad" (LDL) cholesterol and low levels of "good" (HDL) cholesterol are also known risk factors.

Lack of exercise, makes the arteries rigid and inelastic. They are not able to cope with minor variations in blood volume.

Smoking and stress of modern society contribute to many of us dying early. We, members of the Homo Sapiens family have a collective responsibility to prevent the spread of these killer diseases.

Figure 2. Cross-section of artery showing thrombus and artheroma.

This concludes the lecture on the major killers of mankind. In a nutshell, the major killer is arteriosclerosis. Prevention of arteriosclerosis will reduce heart attacks and strokes.