Coronary Heart Disease Risk Factors: Measures for Reduction

Uterine fibroids (UFs) represent the most prevalent non-cancerous tumors among women of reproductive age. Symptomatic fibroids can lead to significant health issues and are the primary reason for hysterectomies in the United States and globally, contributing to substantial socioeconomic impacts and affecting over 70% of women of reproductive age (Langton et al., 2024). African American women tend to develop fibroids approximately 10 years earlier than White women in the US and bear a disproportionate health burden from these tumors

Black women experience UFs at higher rates, with an earlier onset, more severe symptoms, and faster disease progression compared to other groups.

According to Sithembinkosi Ndebele (2024), 85% of participants were non-Hispanic Blacks. Black participants had a higher likelihood of a UF diagnosis, and the following risk factors were reported contributing to the high prevalence of UFs in Black individuals:

1. Socioeconomic Status: Lower socioeconomic status is reported to increase the rates of UFs.
2. Adverse Environmental Exposures: Increased exposure to environmental pollutants is associated with a higher prevalence of UFs.
3. Chronic Stress: Experiences that increase chronic stress are significant contributors.

Lifestyle and socioeconomic factors, closely tied to neighborhood characteristics, further influence UF prevalence. These factors include:

1. Body Mass Index (BMI): A higher BMI correlates with a higher risk of UFs.
2. Alcohol Use: Regular alcohol consumption is positively correlated with UF diagnosis.
3. Income and Occupation: These factors influence access to healthy food and healthcare.

As we know, obesity stands as a significant health concern affecting the lives of African Americans. It is imperative to grasp the barriers that contribute to the rising rates of obesity within this population.

Obesity is characterized by excessive body fat accumulation influenced by environmental and genetic factors and poses various health risks, including specific cancers, type 2 diabetes, hypertension, osteoarthritis, hyperlipidemia, and cardiovascular disease. Omondi & Freysteinson (2023) estimated annual medical expenses related to obesity issues in the United States to be around $147 billion. Research reveals that obesity prevalence is notably high among African Americans, with rates around 49.6%, surpassing non-Hispanic Whites at 42.2%. Mainly, obesity rates are higher among African American women, reaching 56.9%, compared to 41.1% among African American men (Lofton et al., 2023).

Access to nutritious foods is limited for African Americans, who often consume less nutritious diets with high levels of added sugars and fried foods. Multiple obstacles hinder healthy eating habits, including limited knowledge, the cost of nutritious foods, time constraints for meal preparation, reliance on transportation to access stores, and communication barriers with healthcare providers regarding dietary habits.

Similarly, opportunities for physical activity are restricted, exacerbating the obesity issue. Reduced physical activity levels and increased sedentary behaviors like gaming or screen time have been associated with higher body mass index (BMI). African Americans facing obesity encounter various challenges in engaging in physical activity, including a lack of awareness regarding effective exercise methods, limited access to affordable exercise programs, inadequate facilities, transportation limitations, and health concerns.

References

Omondi, H., & Freysteinson, W. M. (2023). Understanding Obesity in African American Women Using Leininger’s Theory. Nursing Science Quarterly, 37(1), 71–75. https://doi.org/10.1177/08943184231207383

Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023). Obesity among African American people in the United States: A review. Obesity, 31(2), 306–315. https://doi.org/10.1002/oby.23640

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Developing new, healthier habits could shield you against life-threatening conditions like diabetes and obesity. Creating new routines that include regular exercise and a healthy diet may also help you lose weight and feel more energized. Here are six strategies to maintain good physical and mental well-being.

1. Make regular exercise a part of your daily routine.: Regular exercise depends on maintaining a healthy weight, building stronger bones and muscles, and enhancing cardiovascular health. On most days of the week, try to get at least 30 minutes of moderate-intensity exercise. Look for things to do that you enjoy, like biking, swimming, dancing, walking, and running.
2. Seek routine medical examinations: See your doctor regularly to ensure preventive care and early detection of potential health issues. Make regular check-up appointments with your physician and abide by their recommendation regarding tests and screenings.
3. Make getting enough sleep a priority: Your body needs rest to rejuvenate and heal. Aim for 7 to 8 hours of sound sleep every night. Make a soothing bedtime ritual, stick to a regular sleep schedule, and abstain from caffeine and screen time right before bed.
4. Manage stress effectively: Your physical and mental health may suffer if you experience persistent stress. Try healthy stress-reduction strategies, like working out, practicing relaxation, or going outside. Consider getting professional assistance if you’re struggling to manage your stress alone.
5. Establish a Support Network: Tell your loved ones, a support group, or friends about your health objectives. Support networks can offer accountability, inspiration, and encouragement. Look for a friend or workout partner who shares your health objectives to foster connections and increase the enjoyment of activities.
6. Prioritize a wholesome diet: Achieve this by managing a healthy weight, enhancing your immune system, and relying on a well-balanced, nutrient-rich diet to supply your body with the essential nutrients needed for optimal functioning.

Limit processed foods, sugar-filled beverages, and high amounts of unhealthy and saturated fats. Instead, concentrate on eating abundant fruits, vegetables, and whole grains.

The prostate is a small, walnut-sized, shaped organ below the bladder and in front of the rectum. The main functions are to create fluids for semen and force semen through the urethra during ejaculation. It is usual for the prostate to get larger as one age.  Because of the location just below the bladder and in front of the rectum, also wrapping around the upper part of the urethra, the tube that carries urine from the bladder out of the body, it means abnormal prostate conditions can affect urination and sexual function. The prostate is prone to three main conditions, which are Prostatitis, an infection or inflammation of the prostate gland; Benign prostatic hyperplasia (BPH), an aging-related enlargement of the prostate gland; Prostate cancer, the growth of cancerous cells inside the prostate, which may break out of the gland and affect other parts of the body.

Prostatitis

This is the inflammation (swelling) of the prostate gland, and common causes include infection (usually bacteria), injury, or an immune system disorder. The symptoms may include the inability to urinate, Painful or difficult urination, and painful ejaculation, accompanied by fever, Blood in the urine (hematuria), and Severe discomfort or pain in the pelvic area or genitals.

The Risk factors for prostatitis include:

Previous prostatitis, Infection of the urinary or reproductive system, HIV infection or AIDS, Use of a tube inserted into the urethra to drain the bladder (urinary catheter), and Diagnostic sampling of prostate tissue (biopsy).

Laboratory tests for Prostatitis include Urinalysis, urine microscopy/culture/sensitivity, HIV, measurement of Prostatic specific antigen levels in the blood, Scan, etc.

Benign prostatic hyperplasia (BPH)

The prostate will almost certainly get larger increasing age. A small amount of prostate enlargement is present in many men over age 40 years of age.  More than 90% of men over age 80 have the condition. It’s not clear why it happens, but it may be linked to the decline in the male sex hormone testosterone with aging. This enlargement is a condition called benign prostatic hyperplasia (BPH).  The key word is benign.  BPH has nothing to do with cancer and doesn’t increase the risk of prostate cancer. It can make urination and ejaculation difficult because as the prostate grows, it presses on the urethra. That interferes with the flow of urine and the release of ejaculate during orgasm. In less than half of all men with BPH, symptoms may include dribbling at the end of urinating, Inability to urinate (urinary retention), Incomplete emptying of the bladder, Incontinence, needing to urinate two or more times per night, Pain with urination or bloody urine (these may indicate infection). Slowed or delayed the start of the urinary stream, straining to urinate, Strong and sudden urge to urinate, and Weak urine stream.

The Link between BPH and Sexual Problems

Scientists aren’t sure why, but they agree that the worse the BPH symptoms are, the more likely an individual is to have sexual issues such as reduced sex drive, trouble keeping an erection, and less sexual satisfaction. It may have something to do with genetics or age. It’s also possible that the sleeplessness or anxiety that can come from an enlarged prostate makes sexual problems worse.

Laboratory Test for BPH.

A digital rectal exam is usually done to feel the prostate gland. Urine flow rate is monitored, Urinalysis to check for blood or infection, Urine culture to check for infection, Prostate-specific antigen (PSA) blood test to screen for prostate cancer, Cystoscopy, Blood urea nitrogen (BUN) and creatinine tests to check for reduced kidney function.

Risk Factors for BPH include;

• Age – symptoms start manifesting by age 50 to 60 in 60% of men.
• Unhealthy diet- daily consumption of a diet high in red or processed meat, saturated fats, and dairy products can increase your risk for prostate problems. Sodium (salt), Alcoholic and caffeinated beverages like coffee, tea, and soda can also increase your risk due to being diuretics that increase urine production.
• Type 2 diabetes, poorly managed Hypertension, and other heart diseases, Smoking, obesity, and a Sedentary lifestyle are common risk factors.
• Prostatitis
• Family history/genetics
• Frequent Urinary Tract infection (UTI)

Prostate Cancer

Cancer is a disease in which abnormal cells divide uncontrollably and destroy body tissue, in the case of prostate, abnormal prostate cells continue to grow until it has destroyed normal body tissues around and beyond the prostate.  Prostate cancer usually develops slowly, so there may be no signs for many years. Symptoms of prostate cancer do not usually appear until the prostate is large enough to affect the tube that carries urine from the bladder out of the penis (urethra). When this happens, one may notice things like increased need to pee, straining while peeing, a feeling that the bladder has not fully emptied. Causes of prostate cancer are largely unknown. However, certain things can increase the risk of developing the condition.

Risk factors for Prostate cancer include;

• Age: The chances of developing prostate cancer increase as one gets older. Most cases develop in men aged 50 or older. Prostate cancer risk begins to rise sharply after age 55 years and peaks at age 70–74, after which it starts to decline. For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
• Men whose fathers or brothers were affected by prostate cancer are at slightly increased risk themselves.
•  Other risk factors include Obesity, Smoking (increases steroid hormone production such as DHT, and estrogen), High levels of pesticides, excessive consumption of dairy products (milk, yogurt, cheese, lactose-free milk, and fortified soy milk and yogurt), excessive red meat consumption, Saturated fat, and Sedentary lifestyle.

Beneficial Foods to Eat

A diet rich in fruits, vegetables, and healthy fats, such as the Mediterranean diet, may benefit health. Salmon, rich in healthy fats that contain omega-3 fatty acids, helps prevent and reduce inflammation within the body, and other cold-water fish, such as sardines and trout, are also rich in these fats.

Tomatoes: Tomatoes are packed with lycopene, an antioxidant that may benefit prostate gland cells. Cooking tomatoes, such as in tomato sauce or soup, helps to release the lycopene and make it more readily available to the body. Berries: Strawberries, blueberries, raspberries, and blackberries are excellent sources of antioxidants, which help to remove free radicals from the body. Free radicals are the byproducts of reactions that occur within the body and can cause damage and disease such as concern over time.

Broccoli: Broccoli and other cruciferous vegetables, including bok choy, cauliflower, Brussels sprouts, and cabbage, contain a chemical known as sulforaphane. This is thought to target cancer cells and promote a healthy prostate.

Nuts: Nuts are rich in zinc, a trace mineral. Zinc is found in high concentrations in the prostate and is thought to help balance testosterone and DHT. Besides nuts, shellfish and legumes are also high in zinc.

Citrus: Oranges, lemons, limes, and grapefruits are all high in vitamin C, which may help to protect the prostate gland.

All these are vital in addition to exercises to strengthen the pelvic floor muscles, such as brisk walking, Kegel exercise, and moderate strength training.

(Written by Ebenezer Dic-Ijiewere PhD.)

Sleep is essential for the health and well-being of children, adolescents, and adults. Quality sleep supports emotional well-being, metabolic health, cognitive function, mental health, and cardiovascular and cerebrovascular health. Additionally, getting sufficient, high-quality sleep helps reduce the risk of fatigue-related accidents and injuries, such as motor vehicle accidents and workplace incidents.

Recommended Sleep Duration

The American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS) recommend that adults aim for at least 7 hours of sleep each night to promote optimal health. Similarly, the National Sleep Foundation (NSF) advises adults to get 7 to 9 hours of sleep per night, with older adults requiring 7 to 8 hours.

Prevalence of Sleep Disorders and Mental Health Impacts

About one-third of the population experiences insomnia symptoms, such as difficulty falling or staying asleep. Additionally, 4% to 26% of individuals report excessive sleepiness, and 2% to 4% have obstructive sleep apnea. Insomnia is associated with a significantly increased likelihood of mental health issues; individuals with insomnia are 10 times more likely to experience clinically significant depression and 17 times more likely to experience anxiety compared to those without insomnia. Poor sleep is also linked to post-traumatic stress, eating disorders, and psychosis spectrum experiences, such as delusions and hallucinations.

Improving sleep Quality

Improving sleep quality benefits mental health, and research reports that sleep plays a causal role in mental health challenges. Better sleep positively affects future mental health, even those without clinical symptoms.

Strategies for Improving Sleep Quality

• Creating a relaxing sleep environment
• Limiting daytime naps
• Managing stress and worries
• Being mindful of food and drink choices
• Sticking to a consistent sleep schedule
• Incorporating physical activity into daily routines.

According to the Centers for Disease Control and Prevention (2021), Cigarette smoking damages almost every organ in the body, leading to numerous diseases and overall health decline. In the United States, smoking is responsible for over 480,000 deaths each year, nearly one in five deaths. For women, smoking can make it more difficult to conceive and can adversely affect a baby’s health before and after birth. In men, smoking can reduce sperm quality, decreasing fertility and increasing the risk of congenital disabilities and miscarriage. Smoking also harms oral health, potentially leading to tooth loss. Moreover, it increases the risk of cataracts, which cloud the eye’s lens and impair vision. It can cause age-related macular degeneration (AMD), damaging a small spot near the retina’s center needed for central vision. Additionally, smoking is a risk factor for type 2 diabetes mellitus and can complicate its management, with active smokers having a 30-40% higher risk of developing diabetes compared to nonsmokers.

The four major diseases linked to smoking are

• Cardiovascular Diseases
  • Increased mortality rates due to smoking.
  • Elevated risk of ischemic heart diseases.
• Respiratory Conditions
  • Smoking is a primary cause of chronic respiratory deaths.
  • Increased risk of respiratory diseases and tuberculosis.
• Stroke
  • A Study reports a Positive correlation between smoking prevalence and stroke-related deaths.
• Lung Cancer
  • Study reports there is a higher likelihood of lung cancer with increased daily cigarette consumption.