Epidemiology of Non
Communicable
diseases and Risk
By Roll no :1 - 12
factors
DEPARTMENT OF COMMUNITY
Katuri Medical College and
MEDICINE
Hospital
Introductio
n
• Non–communicable diseases(NCDs) are medical
conditions or diseases that are not caused by
infectious agents & cannot be transmitted from one
person to another.
• These diseases are typically chronic in nature
• NCDs arise due to a combination of :
• genetic factors
• environmental factors
• lifestyle factors
Introductio
Non – communicable diseases
include n
1.Cardiovascular diseases : 4.Cancer
• heart attacks 5.Obesity
• strokes 6.Musculo-skeletal
• hypertension disorders:
2.Chronic respiratory diseases : • arthritis
• asthma 7.Degenerative diseases :
• chronic bronchitis • Alzheimer’s disease
• emphysema • Parkinson’s disease
3.Diabetes 8.Renal diseases
Problem
statement
• Chronic non – communicable diseases
are assuming increasing importance
among the adult population in both
developed & developing countries
• Cardiovascular diseases & cancer
are at present the leading causes
of death in developed countries
Problem
statement
A total of 68.28 million deaths occurred world
wide during 2021.
Of these , 43.31 million were due to NCD,
principally due to:
• cardiovascular diseases(19million deaths)
• cancer ( 10 million deaths )
• chronic respiratory diseases(4 million)
• Diabetes including kidney diseases(2 million)
Nearly 3/4 th of these NCD deaths ( 31.4 million
about 77%) occurred in low & middle income
countries
India is experiencing a rapid health transition with large and rising
burden of chronic non-communicable diseases cardiovascular dis
(NCDs) especially cardiovascular disease, diabetes mellitus, cancer,
stroke, and chronic lung diseas troke, and chronic lung diseases. It is
estimated that in 2016 NCDs accounted fo accounted for 60 per cent of
deaths.
Risk factors
Risk factors – mainly divided into three
categories
2.METABOLIC FACTORS :
1.BEHAVIOURAL FACTORS : • Obesity
• Tobacco • High blood pressure
• Unhealthy diet • Hyperlipidemia
• Physical inactivity • Hyperglycemia
• Excessive alcohol consumption
3.ENVIRONMENTAL FACTORS :
• Air pollution
• Exposure to U.V radiation
Tobacco
Almost 8 million people die from tobacco use each
year both from direct tobacco use and second hand
smoke (10% of all deaths)
Smoking is estimated to cause about
• 71% of lung cancer
• 42% of chronic respiratory disease
• 10% of cardiovascular disease
The highest incidence of smoking along men is in
lower- middle income countries
Smoking prevelance is highest among upper-middle
income countriues
Unhealthy
• Most of the population consume much higher
diet
levels of salt than recommended by WHO for
disease prevention
• High consumption of saturated fats & trans-
fatty acids raises blood cholesterol levels
• High intake of sugars contribute to weight
gain,obesity & type 2 diabetes
• low fruit & vegetable intake linked to heart
diseases & certain cancers
• low dietary fiber intake leads to type 2 DM &
digestive problems
• High intake of processed foods linked to
obesity, heart diseases
Physical
activity
• Globally 1 in 4 adults don’t meet the global
recommended levels of physical activity
• Upto 5 million deaths a year could be everted if
the global population was more active
• People who are insufficiently active have a 20-
30% increased risk of death compared to
people who are sufficiently active
• More than 80% of the world’s adolescent
population is insufficiently physically active
Excessive Alcohol
Approximately 3.3 million people die each year
consumption
from the harmful use of alcohol accounting for
about 5.9% of all world deaths in the world &
5.1% DAILY were attributable to alcoholism.
More than half of these Deaths occur from NCDs
including :
• Cardiovascular diseases
• Cancer
• Alcoholic hepatitis
• Cirrhosis
• Pancreatitis
Obesit
• At least 2.8 million people die each year as a
y
result of being over weight or obese.
• Raised BMI also increases the risk of certain
cancers, heart diseases, stroke &
diabetes.
High blood
• Raised blood pressure is estimated to cause 9.4
pressure
million deaths,about 12.8% of all deaths
• Major risk factor of cardio-vascular disease
Hyperlipidemia
• Raised cholesterol is estimated to cause 2.6
million deaths annually .
• It increases the risk of heart diseases & stroke.
Hyperglycemia
1.5 million deaths directly attributed to diabetes
It leads to
• Cardiovascular diseases
• Heart attacks
• Strokes
• Diabetic nephropathy
• Diabetic neuropathy
• Diabetic retinopathy
Air pollution UV Radiation
Approximately 3 million deaths 5 million deaths annually are to
annually exposure to uv radiation
Diseases associated with air Risks associated with UV
pollution are radiation exposure :
• Ischemic heart disease • skin cancer such as
• Stroke melanoma
• COPD • SCC
• Lung cancer • BCC
• Pre mature aging , cataract,
photo-keratitis
Prevention of NCDs
PRIMARY PREVENTION
1.TOBACCO CONTROL :
• protecting people from tobacco smoke
• banning smoking in public places
• warning about the dangers of tobacco use
• enforcing bans on tobacco advertising
• raising taxes on tobacco product
2. ALCOHOL CONTOL :
• restricting access to retail alcohol
• enforcing bans on alcohol advertising
• raising taxes on alcohol
Prevention of NCDs
PRIMARY PREVENTION
3. HEALTHY DIET :
• promoting increased intake of healthy foods
• reducing salt intake
• replacing trans fats in food with poly-
unsaturated fats
• raising public awareness about diet &
nutrition
4.PHYSICAL ACTIVITY : encouraging regular
physical activity through mass media
community education
5.STRESS MANAGEMENT
Prevention of NCDs
SECONDARY PREVENTION
1. OPPORTUNISTIC SCREENING OF INDIVIDUALS ABOVE
THE AGE OF 30 YEARS FOR COMMON NCDs
2.Establishing NCD clinics at community health
center,district levels for early detection & treatment
3.Training health care professionals to manage the
increasing burden od NCDs
TERTIARY PREVENTION
• Providing rehabilitative care
• Strengthening tertiary level health facilities for
advanced treatment & care
Integrated
• An integrated approach to NCD prevention involves
approach
addressing common risk factors :
Ex : tobacco use
unhealthy diet
physical Inactivity
harmful use of alcohol through a holistic
programme
This approach includes promoting healthy life styles
through mass media & community education
• Developing medical care systems including primary
health care
• Implementing political measures such as smoking
WHO GLOBAL ACTION PLAN FOR THE PREVENTION
AND CONTROL OF NCD (2013 – 2020 to 2030 )
Voluntary global targets are :
• 1/3 rd relative reduction in risk of pre-mature mortality
from CVD,cancer,diabetes,chronic respiratory diseases
• Atleast 20% relative reduction in the harmful use of
alcohol as appropriate with national context
• 15% relative reduction in prevalence of insufficient
physical activity
• 30% relative reduction in mean population intake of
salt
• 30% relative reduction in prevalence of current
WHO GLOBAL ACTION PLAN FOR THE PREVENTION
AND CONTROL OF NCD (2013 – 2020 to 2030 )
Voluntary global targets are :
• 25% relative reduction in prevalence of raised blood
pressure
• Halt the raise of diabetes & obesity
• Atleast 50% of eligible people receive drug therapy &
counselling to prevent CVD
• 80% availability of the affordable basic technology &
essential medicines including generics required to
treat major NCDs in both public & private facilities
2030 AGENDA FOR SUSTAINABLE DEVELOPMENT
• Target 3.4 calls for a 1/3ʳᵈ reduction in pre-mature
mortality from NCD by year 2030 & is an extension of
the global NCD mortality target
Considering the fact that NCDs are surpassing the burden of
communicable diseases in India and the existing health
system is mainly focussed on communicable diseases, need
for National Programme on Prevention and Control of
Diabetes, Cardiovascular Diseases and Stroke was
envisaged. Later on this programme was integrated with
National Cancer Control Programme, and National
Programme for Prevention and Control of Cancer,
Diabetes, Cardiovascular Diseases and Stroke
(NPCDCS) came into existence. In 2023,the name was
changed to National Programme for Prevention &
Control of Non-Communicable Diseases(NP-NCD).
Diabetes, Cardiovascular Disease and Stroke (DCS)
Component under NPCDCS
The major objectives of the programme are follows:
• Prevent and control common NCDs through behaviour
and lifestyle changes.
• Provide early diagnosis and management of common
NCDs.
• Build capacity at various levels of health care for
prevention, diagnosis and treatment of common NCDs.
• Train human resource within the public health set-up viz
doctors, paramedics and nursing staff to cope with the
increasing burden of NCDs, and
• Establish and develop capacity for palliative &
Cardiovascular
diseases
Cardiovascular diseases (CVD) comprise of a group of diseases
of the heart and the vascular system.
The major conditions are
• Ischemic heart disease (IHD)
• Hypertension
• Cerebrovascular disease (stroke)
• Congenital heart disease.
• Rheumatic heart disease (RHD): continues to be an
important health problem in many developing countries.
Problem statement
WORL
• CVDs are the number one cause of death globally, more people
D
die annually from CVD than any other cause.
• An estimated 19.20 million people died from CVD in 2021,
representing 28.11 per cent of all global deaths.
• Of these global deaths, an estimated 9.02 million were due to
coronary heart disease and 6.97 million were due to stroke.
• At least 82 per cent of the world's deaths from CVDs occur in low
and middle-income countries.
• The poorest people are affected most.
• At the household level, CVD and other NCDs contribute to
poverty due to catastrophic health spending and high out-of-
pocket expenditure.
Problem statement
WORL
• The incidence of CVD is greater in urban areas
D
than in rural areas.
• A peculiar cause of concern is the relative early
age of CVD deaths in the developing countries.
• Ironically CVDs are now in decline in the
industrialized countries first associated with
them.
• The decline is largely a result of the he s
success of primary prevention and to a lesser
extent, treatment.
• The middle and low-income countries are at the
mid-point of the emerging epidemic and will
Problem statement
INDI
• An estimated 2.78 million people
A
died of CVD in India during 2021.
• Compared with all other countries,
India suffers the highest loss in
potentially productive years of life,
due to deaths from CVD in people
aged 35-64 years.
• The prevalence of CVD is reported to
be 2-3 times higher in the urban
population as compared to the rural
population.
Risk factors
🔹 Non-Modifiable Risk Factors
These cannot be changed but are important for risk
assessment:
• Age – Risk increases with age (especially >45 in men
and >55 in women).
• Sex – Males are at higher risk; risk in females increases
after menopause.
• Family history – A positive family history of CVD
(especially at younger ages).
• Genetic predisposition – Certain inherited conditions
(e.g., familial hypercholesterolemia).
Risk factors
🔹 Modifiable Risk Factors
These are the primary targets for public health
interventions:
• Hypertension– A major independent risk factor.
• Diabetes Mellitus – Increases risk due to
vascular complications.
• Dyslipidemia – High LDL, low HDL, and high
triglycerides.
• Smoking and tobacco use – Strongly associated
with increased CVD risk.
Risk factors
🔹 Modifiable Risk Factors
• Physical inactivity – Sedentary lifestyle
contributes to obesity, hypertension, and
diabetes.
• Obesity (especially central obesity) – Increases
risk of hypertension, diabetes, and dyslipidemia.
• Unhealthy diet – High in saturated fats, trans
fats.
• Excessive alcohol intake can cause
hypertension and cardiomyopathy
Risk factors
Others include:
• Socioeconomic status -
lower SES linked to higher
risk of CVD
• Urbanisation- often
associated with lifestyle
changes ,higher risk
• Sleep disorders - especially
obstructive sleep apnea
Interventions to reduce CVD
PRIMARY PREVENTION
burden
The cost effective interventions that are feasible to
be implemented include population-wide
interventions individual level interventions, which
are recommended to be used in combination to
reduce the CVDs.
The example of population- wide intervention
are:
• comprehensive tobacco control policies;
• taxation to reduce the intake of foods that are
high in fat sugar and salt
• building walking and cycle paths to increase
physical activity;
Interventions to reduce CVD
PRIMARY PREVENTION
burden
• At the individual level, individual health-care
interventions need to be targeted to those at
high total cardiovascular risk or those with single
risk factor level above traditional thresholds, such
as hypertension and hypercholesterolemia.
• The former approach is more cost-effective than
the later and has the potential to substantially
reduce cardiovascular events.
• This approach is feasible in primary care in low-
resource settings, including by non-physician
health workers.
Interventions to reduce CVD
SECONDARY PREVENTION
burden
For secondary prevention of cardiovascular disease
in those with established disease, including diabetes,
treatment with the following medications are
necessary:
• aspirin;
• beta-blockers;
• angiotensin-converting enzyme inhibitors; and
• statins.
The benefits of these interventions are largely
independent, but when used together with smoking
cessation, nearly 75% of recurrent vascular events
may be prevented.
Interventions to reduce CVD
In addition costly surgical operations are sometimes
burden
required to treat CVDs. They include:
• coronary artery bypass;
• balloon angioplasty (where a small balloon-like
device is threaded through an artery to open the
blockage);
• valve repair and replacement;
• heart transplantation.
We thank you from the
bottom of our HEARTS
