Human Health and Disorders

This chapter covers common cardiovascular, respiratory and renal disorders seen in Nepal, and the health effects of substance abuse (drugs, alcohol and smoking).

Cardiovascular disorders

• Hypertension (high blood pressure): persistently elevated arterial blood pressure. It is linked to a diet high in salt and fat, obesity, lack of exercise, stress and smoking, and is a major risk factor for stroke, heart attack and kidney disease.
• Atherosclerosis: the build up of fatty deposits (plaques of cholesterol and other lipids) inside artery walls, narrowing the vessel and reducing blood flow; a major underlying cause of coronary heart disease and stroke.
• Coronary heart disease (CHD) and heart attack (myocardial infarction): narrowing or blockage of the coronary arteries, which supply blood to the heart muscle itself, commonly by an atherosclerotic plaque or a blood clot, starving part of the heart muscle of oxygen; presents as severe chest pain, often radiating to the arm or jaw, breathlessness and sweating.
• Angina pectoris: chest pain caused by a temporary, reversible shortage of oxygen to the heart muscle, typically brought on by exertion and relieved by rest, distinct from a heart attack in that no permanent damage occurs.
• Stroke: interruption of blood supply to part of the brain, either by a blocked vessel (ischaemic stroke) or a burst vessel (haemorrhagic stroke), causing sudden loss of brain function.
• Common risk factors: smoking, a diet rich in saturated fat and salt, obesity, physical inactivity, diabetes, and chronic stress; prevention rests on a balanced diet, regular exercise, avoiding tobacco, and control of blood pressure and blood cholesterol.

Respiratory disorders

• Asthma: a chronic condition in which the airways become inflamed and narrowed, often triggered by allergens, cold air, exercise or infection, causing wheezing, breathlessness, chest tightness and coughing; managed with bronchodilator and anti-inflammatory inhalers.
• Bronchitis: inflammation of the bronchial tubes, producing a persistent cough with mucus; it may be acute (usually viral, short lived) or chronic (usually caused by long term smoking or air pollution, and grouped under chronic obstructive pulmonary disease).
• Emphysema: a chronic condition in which the walls of the alveoli (air sacs) are progressively destroyed, reducing the surface area available for gas exchange and causing breathlessness; strongly associated with long term smoking, and grouped together with chronic bronchitis as chronic obstructive pulmonary disease (COPD).
• Pneumonia: infection and inflammation of the alveoli, which fill with fluid or pus and impair gas exchange, causing fever, cough, chest pain and difficulty breathing; caused by various bacteria (commonly Streptococcus pneumoniae), viruses or fungi.
• Occupational and environmental lung disease: prolonged exposure to dust, smoke or indoor air pollution, a particular concern in Nepal where biomass and wood fuel are widely used for cooking, can cause or worsen chronic respiratory disorders.