The Risk Factors: Alcohol Abuse, Smoking, and High Fat Diet - Essay Example

WHAT WILL KILL YOU FIRST: SMOKING, A HIGH FAT DIET, OR ALCOHOL? Department Table of Contents Table of Contents 2 Table of Figures 3 1.0 Introduction 4 2.1 Epidemiology and Prevalence 4 3.0 Pathophysiology and Pathology 7 3.1 Respiratory System 7 3.1.1 Effects of Smoking on the Respiratory System 7 3.1.2 Effects of High fat Diet on the Respiratory System 7 3.1.3 Effects of Alcohol on the Respiratory System 8 3.2 Cardiovascular System 10 3.2.1 Effects of Smoking on Cardiovascular System 10 3.2.2 Effects of High fat Diet on Cardiovascular system 10 3.2.3 Effects of Alcohol on Cardiovascular System 12 4.0 Emergency Medical Management 12 4.1 Acute Coronary Syndrome 12 4.1.1 Diagnosis 13 4.1.2 Treatments 13 4.1.3 Complications 14 4.2 Acute Obstructive Pulmonary Disease 14 4.2.1 Diagnosis 15 4.2.2 Treatments 15 4.2.3 Complications 16 5.0 Summary and Conclusions 16 References 18 Table of Figures Figure 1 Proportion of global NCD deaths under the age of 70, by cause of death, 2008 6 Figure 2: Mechanism for Clinical damage of the respiratory system 9 Figure 3 Mechanism for Clinical damage of the cardiovascular system 11 1.0 Introduction Risk factor refers to the behaviouralconditions that increase an individual’s susceptibility to a condition or disease. There is always interaction between the internal genetic makeup of individuals and the external factors such as alcohol abuse, smoking and diet. Research has shown that these factors often conspire with the internal genetic mutations thus resulting into the destabilization of the appropriate checks and balances necessary for normal growth and functioning of body organs and organ systems. While doctors professionally explain why people develop diseases, and others don’t, researchers have particular singled out specific risk factors that increase individual’s vulnerability to developing certain types of diseases or conditions. The effects of cigarette smoking, alcohol abuse and high fat diet on the development of respiratory and cardiovascular diseases are well documented. It is however difficult to disentangle the effects of smoking and alcohol since the two tends to be correlated because many smokers are also heavy alcohol abusers. However, all these factors have serious risks to the normal function of the respiratory and cardiovascular systems. It is therefore important to note that one can reduce their risk of early death by taking a lifestyle change and reducing smoking, alcohol and high fat diet. This study examines a comprehensive review of peer reviewed journals in order to evaluate the risk factors; alcohol abuse, smoking and high fat diet on the respiratory and cardiovascular systems, pathophysiology and also to identify possible emergency medical management. 2.1 Epidemiology and Prevalence Epidemiologic evidence of lung cancer is very important since it forms the basis for early intervention practices as well as treatment interventions. While evaluation of the risk factors play key role in prevention of respiratory and cardiovascular systems’ disorders, epidemiologic evidence is crucial in assessing the effectiveness of the interventions programs. The use of tobacco and exposure has been linked to various forms of cancer due to its carcinogenic chemicals. According to Hoffmann et al (2013 p.2), tobacco smoke contains50 carcinogenic chemicals out of 400 chemicals. The World health Organization estimates the world population of smokers to be consuming 6 trillion of cigarettes annually. However, this excludes the second hand smokers who are also at high health risk. According to World Health Organization, annual tobacco related deaths are expected to by 10 percent to eight million by 2030 if something is not done. Alcohol abuse is a health risk that result into many disorder of the cardiovascular system. It is estimated that alcohol abuse was responsible approximately 2.3 million deaths worldwide during the year 2004 which is approximately 4 percent of all deaths in the world during that year (Costanzo et al 2011 p.119). This report also states that more than half of these deaths were caused by non-communicable diseases like cancer, liver cirrhosis and cardiovascular diseases. Research also show that there is relationship between ischemic heart diseases and alcohol consumption and is mainly determined by the amount and the pattern of alcohol consumed. Alcohol consumption varies greatly across the world with global per capita consumption of alcohol approximated at six liters in the year 2008 (WHO, 2011 p.19). However, Europe leads with 12.2 and Mediterranean last with 1 liter. Figure 1 Proportion of global NCD deaths under the age of 70, by cause of death, 2008 Source: WHO, Global status report on noncommunicable diseases 2010. Correlation between unhealthy diet and particularly high fat diet and death is not possible. However, it is important to note that high fat diet contributes to high percentages of deaths associated with obesity, diabetes, atherosclerosis and heart diseases. According to Costanzo (2011 p.119), consumption of high fat diets have been linked to 1.7 million deaths worldwide due to various complications arising from the disorders of the cardiovascular system. Research also show that high energy foods such as sugar and high fats diets mainly from processed foods lead to overweight, obesity and diabetes compared to low energy foods (Costanzo, 2011 p.120). This study also reported that the risk of coronary heart diseases is closely linked to the increased intake of saturated fats and trans-fat but unsaturated fats reduce this risk. Figure 1 shows percent non communicable disease (NCD) deaths resulting from lifestyle. 3.0 Pathophysiology and Pathology 3.1 Respiratory System 3.1.1 Effects of Smoking on the Respiratory System Smoking has serious impacts on the respiratory system by affecting the airways. When smoke is inhaled, it moves down deeply into the respiratory tract and due to the moist nature of the tract, more soluble gases are adsorbed while the larger particles are left deposited on the walls of the airways as well as the tiny alveoli. The respiratory system is made up of various defence mechanisms that ensure the lungs and the respiratory system in general is well protected. These include; reflexes and cough responses, epithelial lining, physical barriers, alveolar microphages, mucociliary apparatus and immune response. However, these defence mechanisms are often overwhelmed by the nature of toxicity and quantity of smoke inhaled (Hoffmann et al 2013 p.11). Smoking has severe effects on both the structure and the immune system of the respiratory system. As outlined earlier in the introduction of this study, smoke contains over 400 chemicals of which 400 are considered carcinogenic (WHO, 2011 p.17). The accumulation of smoke and these toxic substances over a long period of time results into: mucous gland hypertrophy and loss of cilia, epithelial changes, inflammation, destruction of alveoli and secretory congestion on the upper airways (Hoffmann et al, 2013 p.10). There are also severe effects on the bronchial tree cells which results into squamous metaplasia. This damage may result into Chronic Obstructive Pulmonary Disease (COPD), lung cancer, Pneumonia, asthma among others. 3.1.2 Effects of High fat Diet on the Respiratory System High fat diets are high energy diets that when consumed takes longer time to be digested and do not therefore provide ready sources of energy. When fats are stored as adipose tissues and accumulates within the body, it results into increase in weight and possible overweight and obesity. Research has shown that overweight, obesity or excess deposits of fats within the body tissues have severe effects on the respiratory system (Verbraecken & McNicholas, 2013 p.3). Obesity affects the respiratory systems in various ways: One is through reduction of the respiratory compliance and the second through mechanical factors. According to Verbraecken (2013 p.7), obesity is characterized by increased weight in the thoracic cavity and thus resulting into obesity hypoventilation syndrome (OHS) characterized by alveolar hypoventilation. This study also asserts that severe overweight and obesity as a result of taking high fat diet can lead to sleep apnea with elevated responsiveness to hypoxemia and carbon dioxide and impair the normal function of respiratory muscles. 3.1.3 Effects of Alcohol on the Respiratory System Alcohol abuse has been reported to be a serious risk factor for the normal functioning of the respiratory system. According to Ibrahim et al (2005 p.374), alcohol consumption has the potential of damaging the lungs and the respiratory system in general. However, the association between respiratory injury and alcoholism is not well accepted by lung researchers. Ibrahim et al (2005 p.375) also asserts that the pathophysiology of alcohol related lung diseases is complex because alcohol is likely to interact with the pathogenic cascade which may result into lung disease. However, other researchers have proposed certain pathophysiology for chronic alcohol related respiratory diseases. Heavy intake of alcohol for a long period of time results into the impairment of various critical cellular functions within the respiratory system especially the lung. It is after the impairments of these cellular functions that individuals are made susceptible to respiratory diseases such as the Acute Respiratory Distress Syndrome (ARDS) (Shield et al 2013 p.158). The mechanism includes the reduction of the levels of glutathione antioxidants levels within the lungs as a result of alcohol metabolism. This affects the cells thus lung will not be able to remove fluid, affects the immune system and reduces the ability of cells to recover from injury (Ibrahim et al 2005 p.376). The combination of these three factors therefore leads to impaired functions of cilia and gag reflex. In this respect, other conditions and disorders are likely to affect the respiratory system such as cancer, pneumonia, Chronic Obstructive Pulmonary Disease (COPD), bronchitis, tuberculosis, pleurisy, empyema among others. Figure 2 shows the Mechanism for Clinical damage of the respiratory system. Figure 2: Mechanism for Clinical damage of the respiratory system Source Ibrahim et al (2005) 3.2 Cardiovascular System 3.2.1 Effects of Smoking on Cardiovascular System Smoking has severe health effects on the cardiovascular system. Many researchers who conducted a study into this health risk have confirmed that smoking damages the blood vessels and results into various cardiovascular diseases. As stated by Bacaksiz et al (2013 p.160), cigarette smoke contain nicotine and carbon monoxide which serve to manage the cardiovascular system during blood circulation. The pathophysiology of cardiovascular diseases begins by binding of the carbon monoxide and hemoglobin in the lungs as blood carries oxygen. This reduces the amount of oxygen that is taken to the body tissues due to the dilution of oxygen by carbon monoxide from cigarette (Blank et al, 2011 p.875). The accumulation of more nicotine, carbon monoxide and other toxic substances results into the stickiness of the blood vessels and cells. The amount of fatty materials that builds up within the blood stream leads to the formation of clots, a condition referred to as atherosclerosis which results into high blood pressure (Pretorius, 2012 p.241). According to Bacaksiz et al (2013 p. 161), nicotine from cigarette smoking causes longer or short term increase in heart rate, blood pressure, coronary blood flow and cardiac output. A number of cardiovascular diseases are caused by smoking including COPD 27%, Ischemic Heart Disease 13%, Stroke 4%, and other heart diseases 12% (Blank et al 2011 p.877). 3.2.2 Effects of High fat Diet on Cardiovascular system Diet plays a key role in the development and management of cardiovascular diseases. Research shows that high blood fat levels exhibit a strong correlation with the risks of coronary artery disease, stroke, heart attack and many other cardiovascular diseases (Munson& Traister, 2005 p.148). The presence of high amounts of saturated fats in blood is an indication of intake of the same from diets and includes: cakes, fast foods, cheese, cookies and foods prepared by animal fats. Animal fats have been linked to high amounts of saturated fats and cholesterol which if present in the blood at high quantities is harmful (Milicevic et al 2014 p.10). It is however important to note that unsaturated fats, monounsaturated fats and polyunsaturated fats are beneficial to the heart. Figure 3 Mechanism for Clinical damage of the cardiovascular system Elevated Plasma Cholesterol LDL Fibrosis, Calcification Degenerative Changes Stimulus (Stress) Interference with Tissue O2 Supply Source: (Milicevic et al 2014) The pathophysiology of high fat diet can be described in two ways. The first way is that high fat diet is likely to contribute to overweight since it contains up to nine calories per gram compared to carbohydrates and proteins. The second way is that saturated fats and cholesterol can be deposited along the walls of arteries and other blood vessels leading to atherosclerosis (Ashton, 2011 p.169). Continued accumulation of fat deposits narrows the blood vessels thus restrict or totally block the blood flow leading high blood pressure, heart attack and chest pain. These are characteristics of cardiovascular diseases: acute coronary syndrome, ischemic disease, heart attack, stroke and peripheral vascular disease (Munson& Traister, 2005 p.148). 3.2.3 Effects of Alcohol on Cardiovascular System Alcohol affects the cardiovascular system by manipulating the blood pressure. Alcohol is consumed, absorbed to the body and into the blood stream hence distributed all over the body tissues, organs and systems. Alcohol affects the physiochemical properties as well as the biological function of the cell membrane (Shield et al, 157). However, the study of the interaction between the blood pressure and intake is complex since acute and chronic actions show divergent results. Research shows that while chronic alcohol administration leads to high blood pressure, acute administration lowers it (Shield et al, 2013 157). In this respect, the acute effect and chronic effects are quite different. Figure 3 shows Mechanism for Clinical damage of the cardiovascular system. 4.0 Emergency Medical Management 4.1 Acute Coronary Syndrome Acute Coronary Syndrome (ACS) refers to the clinical conditions exhibited as a result of rapture of the plague, an unstable lipid rich substance. This rapture leads to adhesion of the platelets, formation of a fibrin clot and a subsequent activation of thrombin (Boden et al 2012 p.521). A good example of (ACS) is Acute Myocardial Infarction, unstable angina and Q-wave and non-Q-Wave (Foody, 2014 p.S4). Cardiovascular disease is the leading cause of death in many developed countries including the US and Britain. Myocardial Infarction and other cardiac damages cause many deaths than any other cardiac disease (Boden et al 2012 p.522). As outlined earlier, this complication is mainly caused by smoking and high fat diets 4.1.1 Diagnosis There are various tests that the doctor can perform to confirm (ACS) especially when a patient shows signs of heart attack. The first test known as Electrocardiogram (ECG) is done to test the impulses since injured or damaged muscles do not conduct impulses normally (Boden et al 2012 p.523). This test is a leading and is likely to reveal more information about the heart especially whether heart attack has occurred or is in the process of occurring. In case there is indication of damaged heart, blood tests is often done to confirm since there is tendency of certain enzymes to leak into the blood when the heart is damaged. Other tests are also done to examine the heart and the blood vessels whether they are damaged or narrowed. They include chest X-ray, Computerized tomography (CT) angiogram, nuclear scan, coronary angiogram mainly to examine the heart (Gelfand & Cannon, 2009 p.28). 4.1.2 Treatments The diagnostic tests that are done to examine the structure are very important in determining the cause a treatment would take. As stated by Ken et al (2014 p.3), the treatment recommendations for Acute Coronary Syndrome varies depending on the clinical signs and the degree of blockage of arteries (ACS). For suspected acute Coronary Syndrome, aspirin is often administered in an emergency room. The role of aspirin is to decrease the blood clotting thus enable blood to flow through narrowed heart arteries. This can be administered as an 80 milligram oral tablet to be chewed daily (Peer et al 2013 p.6). Thrombolytic is also another medication for ACS. They are normally clot busters that are given for emergency patients in order to dissolve the blood clots that are blocking blood flow to the heart. As Costanzo, 2011) states emergency patients’ survival is increased by giving the drug as soon as possible. Other drugs are also administered to relax the heart and affected blood vessels by widening and reducing blood pressure thus reduces pain. They include: beta blockers, Nitroglycerin, calcium Channel blockers, Clot Preventing drugs as well as Cholesterol level reducing drugs. However, sometimes the drugs mentioned above may not be satisfactory in restoring blood flow through the heart hence the doctor may recommend a surgery. There are two types of surgery that can be done to save an emergency case of ACS; Coronary bypass surgery and angioplasty and stenting surgery (Boden et al 2012 p.525). 4.1.3 Complications The most common complication of ACS is the failure of the left ventricular pump. However, other complications are also common and all these complications arise from failure or dysfunctional ischemic tissue or necrotic tissue during the acute phase and completion of infarction respectively (Gelfand & Cannon, 2009 p.148). This often results into hemodynamic disturbances, conduction disturbances and mechanical complications due to necrosis. The complications often occur on average of 20% of acute (MIs) and emergency nurse is therefore expected to be a critical thinker in order to manage complications before, during and after acute phase. 4.2 Acute Obstructive Pulmonary Disease Chronic Obstructive Pulmonary disease refers to the diseases of the respiratory system including emphysema, chronic bronchitis and the chronic obstructive of the airways. As outlined early in this text, this disease is characterized by difficulties in breathing mainly because of the narrowing of the airways resulting into obstruction. It is characterized by increased breathing, persistent coughs, and chest infections (Kvangarsnes et al 2013 p.30). 4.2.1 Diagnosis It is recommended that people who exhibit COPD symptoms are diagnosed as soon as possible to reduce the damages that occur on the lungs. The first diagnostic test conducted by doctors is to confirm how the lung is functioning using a spirometry test. This is the test that is done by measuring the quantity or the volume of air a patient can breathe out in a one second referred to as Forced Vital Capacity (FVC) and Forced Expiratory Volume respectively (FEV) (Kvangarsnes et al 2013 p.26). This test will tell if there is a serious obstruction due to low volumes. Other tests that compliment spirometry include X-ray to show the structure of the lung and eliminate lung cancer and blood tests to eliminate anemia (Peer et al 2013 p.9). Further tests may also be required for some patients: Electrocardiogram, peak flow test, phlegm sample, blood oxygen levels and breathing tests. 4.2.2 Treatments There is no specific treatment for COPD due to the damages that have already occurred on the respiratory tract. However, the severity can be reduced by using inhalers and certain medications. Individuals must first stop smoking and in severe cases, there are certain medications that are administered. Theophylline tablets can be used together with the inhalers to relax the airways and hence open them up (Akpinar et al 2013 p.375). There are also other drugs that are used to reduce the thickness of mucus along the respiratory tract thus enables it to flow and easier to cough out and reduce obstruction (Akpinar et al 2013 p.376). COPD is often accompanied by certain infections that my also require antibiotics in the short run. Others for severe cases include nebulized medication, non-invasive ventilation and long term oxygen therapy (Akpinar et al 2013 p.377). 4.2.3 Complications The major complication associated with COPD is acute exacerbations which result from the sudden obstruction of the airways and worsening of the symptoms. This is mostly due to inflammation along the airways often associated with infection (Gao et al 2013 p.e57678). Exacerbations can also be caused by exposure to irritants, certain medications, seasonal changes and inhalation of toxic substances. Other complications associated with COPD include; lung cancer, osteoporosis, gastro-esophageal reflux, heart disease due to low oxygen supply to the body. 5.0 Summary and Conclusions In conclusion, lifestyle and risk factors; smoking, high fat diet and alcohol abuse present serious health challenges to health professionals. While the three risk factors affect both respiratory and cardiovascular system, smoking is more severe in both. Smoking is also enlisted as a leading risk factor for respiratory and cardiovascular diseases. Epidemiological ad prevalence data show that smoking is still the leading cause of disease across the world including lung cancer and Acute Coronary Syndrome which are the major causes of death. While relation between alcohol cardiovascular diseases is not well documented, there is a lot of evidence that alcohol do not affect cardiovascular system. This study shows that high fat diet comes second after smoking with regard to cardiovascular and respiratory disorders. The risk factors can also lead to serious impairment of the cardiovascular and respiratory system and result into acute coronary syndrome and chronic obstructive pulmonary disease respectively. These are broader categories of disorders that include many other diseases and can be prevented by adopting a lifestyle change. References Akpinar, S, Rollas, K, Akpinar, E, Alagöz, A, Uçar, N, & Şipit, Y 2013, Effect of the presence of pneumonia on noninvasive ventilation success in chronic obstructive pulmonary disease cases with acute hypercapnic respiratory failure, Turkish Journal of Medical Sciences, 43, 3, pp. 373-378. Ashton, A, 2011, Advances in Cardiovascular System Research and Application: 2011 Edition, Atlanta: Scholarly Editions. Bacaksiz, A, Kayrak, M, Vatankulu, M, Ayhan, S, Sonmez, O, Akilli, H, Aribas, A, Ari, H, & Ozdemir, K 2013, The Effect of Smoking on Myocardial Performance Index in Middle-Aged Males after First Acute Myocardial Infarction, Echocardiography, 30, 2, pp. 155-163, Blank, M, Nasim, A, Hart, A, & Eissenberg, T 2011, Acute Effects of Cigarillo Smoking, Nicotine & Tobacco Research, 13, 9, pp. 874-879 Boden, H, van der Hoeven, B, Karalis, I, Schalij, M, & Jukema, J 2012, Management of acute coronary syndrome: achievements and goals still to pursue. Novel developments in diagnosis and treatment, Journal Of Internal Medicine, 271, 6, pp. 521-536 Costanzo, S, Di Castelnuovo, A, Donati, M, Iacoviello, L, & de Gaetano, G 2011, Alcohol Consumption in Relation to Vascular and Total Mortality in Patients with Diabetes, Hypertension or History of Cardiovascular Disease: A Meta-analysis, Journal Of Wine Research, 22, 2, pp. 119-122 Foody, J 2014, Antiplatelet Therapy in Women with Acute Coronary Syndrome, Journal Of Family Practice, 63, pp. S3-S8. Gao, P, Zhang, J, He, X, Hao, Y, Wang, K, & Gibson, P 2013, Sputum inflammatory cell-based classification of patients with acute exacerbation of chronic obstructive pulmonary disease, Plos One, 8, 5, p. e57678. Gelfand, E, & Cannon, C 2009, Management Of Acute Coronary Syndromes, Chichester, UK: Wiley-Blackwell Hoffmann, R, Zarrintan, S, Brandenburg, S, Kol, A, de Bruin, H, Jafari, S, Dijk, F, Kalicharan, D, Kelders, M, Gosker, H, ten Hacken, N, van der Want, J, van Oosterhout, A, & Heijink, I 2013, Prolonged cigarette smoke exposure alters mitochondrial structure and function in airway epithelial cells, Respiratory Research, 14, 10, pp. 1-13, Ibrahim, A, Dikin, M, & Soubani, A 2005, Critical Care Aspects of Alcohol Abuse, Southern Medical Journal, 98, 3, pp. 372-381 Ken, K, Yasuhiko, N, Hironori, K, Toru, M, Hiroyoshi, Y, Koji, Y, Tohru, F, & Iichiro, S 2014, High serum C1q-binding adiponectin levels in male patients with acute coronary syndrome, Cardiovascular Diabetology, 13, 1, pp. 2-14. Kvangarsnes, M, Torheim, H, Hole, T, & Öhlund, L 2013, Intensive care unit nurses perceptions of patient participation in the acute phase of chronic obstructive pulmonary disease exacerbation: an interview study, Journal Of Advanced Nursing, 69, 2, pp. 425-434. Milicevic, D, Vranic, D, Mašić, Z, Parunovic, N, Trbovic, D, Nedeljkovic-Trailovic, J, & Petrovic, Z 2014, The role of total fats, saturated/unsaturated fatty acids and cholesterol content in chicken meat as cardiovascular risk factors, Lipids In Health & Disease, 13, 1, pp. 2-22 Munson, C. & Traister, R, 2005, Pathophysiology: A 2-in-1 Reference for Nurses, Ambler: Lippincott Williams and Wilkins. Peer, N, Bradshaw, D, Laubscher, R, Steyn, N, & Steyn, K 2013, Urban--rural and gender differences in tobacco and alcohol use, diet and physical activity among young black South Africans between 1998 and 2003, Global Health Action, 6, pp. 1-10 Pretorius, E 2012, Ultrastructural Changes in Platelet Membranes due to Cigarette Smoking, Ultrastructural Pathology, 36, 4, pp. 239-243 Shield, K, Parry, C, & Rehm, J 2013, Chronic Diseases and Conditions Related to Alcohol Use, Alcohol Research: Current Reviews, 35, 2, pp. 155-173. Verbraecken, J, & McNicholas, W 2013, Respiratory mechanics and ventilatory control in overlap syndrome and obesity hypoventilation, Respiratory Research, 14, 11, pp. 1-17 WHO, 2011. Global status report on noncommunicable diseases 2010, Geneva: World Health Organization Press. Read More