5 Most Dangerous Health Threats

In June, 2011, the World Health Organisation released a fact sheet detailing the top 10 causes of death in low, medium and high-income countries (WHO, 2011). Pharmaceutical International take a look at some of the major killers, and highlight some recent research on the treatment of these conditions.

Top 10 causes of deaths in high income countries.  Together, they account for around 52% of all deaths in high income countries.

Ischaemic Heart Disease

Ranked top in high-income countries, Ischaemic heart disease (IHD) is responsible for 12.8% of all deaths worldwide. IHD involves a restricted supply of blood to the heart muscle, with symptoms including chest pains, heart attacks, angina and heart failure.

Risk factors for IHD include age, smoking, cholesterol, diabetes and high blood pressure, and many treatments are available to limit these factors. Depending on the symptoms, IHD may be treated by bypass surgery or angioplasty, or managed with drugs to lower cholesterol and blood pressure. In 2011, we reported on the value of blood-thinning and anti-cholesterol drugs for treating heart disease, and discussed the role of heart disease screening.

Stroke

A stroke is a sudden deterioration in brain functions caused by an interruption of the blood supply to the brain - generally due to either an arterial blockage or a haemorrhage (loss of blood). Risk factors include cholesterol, diabetes, smoking, alcohol and drug use. Pharmaceutical treatments for prevention of strokes typically focus on lowering blood pressure (with antihypertensive drugs), lowering cholesterol (with statins) and reducing coagulation of the blood (with anticoagulants such as aspirin and thienopyridenes). Surgical treatments may also be used to treat narrowing of arteries, though these can be dangerous procedures.

Trachea, Bronchus, Lung Cancers

The third biggest killer in high income countries is cancer of the lungs, bronchus and trachea. There are two broad classes of lung cancer: small cell, which can be treated by either radiotherapy or chemotherapy and non-small-cell, which may be treated by radiotherapy, chemotherapy or surgery(Macmillan, 2012).

In the case of chemotherapy, there are a growing multitude of drugs available, each with different strengths and side effects. Commonly used treatments cisplatin and carboplatin. In 2012, we have reported on new research into novel cancer therapy and gallium based anti cancer agents with important implications for the treatment of cancer.

Alzheimer's and Dementias

Alzheimer's is the most common of the dementias. Its initial symptoms include trouble in recalling recent events, but the disease is incurable, and becomes more serious as it progresses. Later symptoms include confusion, mood swings, a decline in bodily functions, and eventually, death. There are currently no cures for Alzheimer's and most treatments focus on relieving symptoms, delaying the onset of the disease and reducing suffering in patients. However, research is ongoing, and Pharmaceutical International has reported on recent studies into new drug development methods to breach the blood-brain barrier, with important implications for the treatment of Alzheimer's disease in the future.

Lower Respiratory Infections

The fifth most common killer in high-income countries is lower respiratory diseases. These include pneumonia, acute bronchitis and lung abscess. Lower respiratory infections may be caused by a range of underlying causes including bacteria, viruses (including MRSA) and fungi. With the proper treatment, mortality is generally very low, but this depends on a fast diagnosis of the disease. Also, the death rate also varies according to the cause of the disease. If patients develop pneumonia from MRSA whilst on a ventilator, they have around a fifty percent chance of death.

Disease in the Developing World

High earning nations are fortunate - we are protected against many of the leading killers affecting low-income countries, and the world as a whole. We have clean water supplies and ready access to medical expertise and equipment. We also have health education, and ready access to contraceptives.

In the developing world, there is limited access to both effective treatment and diagnosis. For this reason, in low-income countries, lower respiratory diseases are the leading cause of mortality, accounting for over 11% of deaths. Second on the list are diarrhoeal diseases caused by a range of infections, and exacerbated by malnutrition. These diseases are potentially both treatable and preventable. In 2011, we reported on new funding for poor nation vaccines to prevent pneumonia, diarrhoea and other

Third on the list is AIDS, accounting for almost eight percent of deaths in low-income countries, and partially preventable by vaccination, education and use of contraceptives. AIDS is currently treatable with antiretroviral drugs, but it is not curable and even after treatment, patient lifespans are typically under 20 years from the time of diagnosis. , though work has been carried out into the development of HIV vaccines to protect against the disease, and reduce rates of reinfection.

Ischaemic heart disease - the top killer in high income countries - appears fourth on the list for the lowest-earning countries. The fifth on the list is Malaria - a largely mosquito borne disease, particularly widespread in Africa. Preventative measures include the eradication of mosquito species' known to transmit the virus, and the use of vaccinations to guard against the disease. In a recent Malaria vaccine trial, vaccination was shown to reduce the rate of infection in adults by over 50%. Malaria is fully treatable with the proper medication - usually by artemisinin and other antimalarials taken orally. In severe cases, it may be treated with quinine, artesunate, or other drugs delivered by parenteral techniques. However, the situation has been complicated by the introduction of fake malaria drugs into the African supply chain.  The disease frequently recurs if not fully removed in its initial treatment. 

References:

WHO, 2011. The top 10 causes of death [online], http://www.who.int/mediacentre/factsheets/fs310/en/index.html [Accessed 1 May 2012]
Macmillan Cancer Support, 2012. Lung cancer [online],
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Lung/Lungcancer.aspx [Accessed 1 May 2012]