PE-1-5Module-5

Fitness and Wellness | Module 5
Cardiovascular Disease
Objectives:
 Define and identify cardiovascular
diseases
 Asses personal risk of cardiovascular
disease
The most important behavioral risk factors of heart disease and stroke are
unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The
effects of behavioral risk factors may show up in individuals as raised blood
pressure, raised blood glucose, raised blood lipids, and overweight and obesity.
These “intermediate risks factors” can be measured in primary care facilities and
indicate an increased risk of developing a heart attack, stroke, heart failure and other
complications.
Cessation of tobacco use, reduction of salt in the diet, consuming fruits and
vegetables, regular physical activity and avoiding harmful use of alcohol have been
shown to reduce the risk of cardiovascular disease. In addition, drug treatment of
diabetes, hypertension and high blood lipids may be necessary to reduce
cardiovascular risk and prevent heart attacks and strokes. Health policies that create
conducive environments for making healthy choices affordable and available are
essential for motivating people to adopt and sustain healthy behavior.
UEP- PE Department | PE 1 (Fitness and Wellness) 1

There are also a number of underlying determinants of CVDs or "the causes

of the causes". These are a reflection of the major forces driving social, economic
and cultural change – globalization, urbanization and population ageing. Other
determinants of CVDs include poverty, stress and hereditary factors.
What is Cardiovascular disease?
Cardiovascular disease (CVD) generally refers to conditions that involved

narrowed blocked vessels. The term is often used interchangeably with one disease.
However, heart disease is just one type of cardiovascular disease. Other types of
CVD include stroke, high blood pressure, angina (chest pain) and rheumatic heart
disease. This chapter will focus on heart disease and strokes.
Heart disease
Heart disease is disorder of blood vessels that can

lead to heart failure. This disorder can be congenital
and/or the result of lifestyle. Most people associate
heart disease with heart attacks. A heart attack, also
known as a myocardial infarction, happens when
artery becomes blocked preventing oxygen and
nutrients from getting to the heart. When a person is
experiencing a heart attack, they will have crushing
chest pains, profound shortness of breath, left arm pain, radiating pain or middle
back pain. These symptoms indicate that a person should seek immediate medical
assistance.
Other types of heart disease include:
 Coronary artery disease, damage or disease

in the heart’s major blood vessels
 High blood pressure. A condition in which
the force of the blood against the artery
walls is too high.
 Cardiac Arrest: Sudden, unexpected loss of
heart function, breathing and
consciousness.
 Congestive heart failure: A chronic condition
in which the heart does not pump blood as
well as it should.
 Arrhythmia: Improper beating of the heart, whether irregular, too fast or too slow.

 Peripheral artery disease: A circulatory condition in which narrowed blood

vessels reduce blood flow to the limbs.
 Congenital heart disease. An abnormality in the heart that develops before birth.
Many people believe incorrectly that heart disease can be cured with surgery
and medication. This is a myth. Heart disease is lifelong condition. Although
procedures, such as bypass surgery, can increase remain damaged. Additionally,
this condition will steadily worsen without major lifestyle change.
Stroke
Strokes are the fifth leading cause of

death and a leading cause of disability in the
United States. This type of CVD affects the
arteries leading to the brain and blood vessels
within the brain. A stroke occurs when a blood
vessel that carries oxygen and nutrients to the
brain is either blocked by a clot or ruptures.
When that happens, part of the brain cannot get
the blood and oxygen it needs and as a result,
brain cells begin to die.
A stroke that occurs as the result of a blockage is called an ischemic stroke. A

hemorrhagic stroke is the result of a rupture and accounts for only 20% of all strokes.
The Cincinnati Stroke Scale provides early warning signs of a stroke:
 F= Face: Is one side of the face drooping down?

 A= Arm: Can the person raise both arms, or is one arm weak?
 S= Speech: Is speech slurred or
confusing?
 T= Time: If the conditions listed above
are present call 9-1-1 immediately! Time
is critical!
What Causes CVD?
The conditions listed below, all of

which are beyond a person’s control, can be
linked to cardiovascular disease:

 Age
There is a strong correlation between CVD and age. As a person ages, the
risk for CVD increases also. Although, with males, the risk seems to be when they
are younger and females seem to be at higher risk post-menopausal.
 Sex
Males have a higher risk for CVD, especially at younger ages. Women
experience higher risk later in their lives. Click on the link below to learn more
about The Heart Truth Program, a program focused on raising awareness about
women’s risk for heart disease and ways for reducing that risk:
 Race
African Americans have the highest risk factor for CVD.
 Family History/Race
A person’s genes can be one of the strongest predictors of CVD, but also has
the smallest correlation to CVD overall.
The 4 conditions listed below are also linked to cardiovascular disease but are
also linked to cardiovascular disease but are within a person’s power to change:
 Tobacco use
The strongest predictor of CVD is the use of tobacco. The use of tobacco
accounts for 30% of CVD risk. There is a significant reduction in risk for those
who do use tobacco.
 Obesity
Those that have a BMI greater than 30 have a higher than normal risk than
those that do not have a BMI greater than 30. “The” obesity epidemic” experienced
by the United States over the past several decades threatens to reverse important
progress against heart disease.
 Diet

CVD can be correlated to high intake of saturated fat and cholesterol. Risk of
dietary cholesterol intake can be correlated to atherosclerosis.
 Diabetes
This condition is viewed as seriously as any of the other factors, such as

smoking, high blood cholesterol, that a person can control. In fact, those with Type II
diabetes have the same level of risk for a heart attack as those who have already
had a heart attack.
BREAK
Feeling exhausted with the mental workout? Let’s have a break and use a little of your
physical energy. Stand and stretch that muscles, finish 30 steps around your house.
Then get some air, slowly inhale and exhale for 3 times. And we’re done.
Personal Risk Assessment
What Is Your Number?
The following screening tests are used to a assess a person’s risk for developing
CVD
 Lipoprotein Profile
What: A blood test that measures total cholesterol, LDL “bad” cholesterol, HDL
“good” cholesterol, and triglycerides (another form of fat in the blood). The test
given after a 9- to 12-hour fast.
Why: To find out if you have any of the following: high blood cholesterol (high
total and LDL cholesterol), low HDL cholesterol, or high triglyceride levels. All
effect your risk for heart disease.
When: All healthy adults should have a lipoprotein profile done at least once
every 5 years. Depending on the results, your doctor may want to repeat the
test more frequently.
 Blood Pressure
What: A simple, painless test using an inflatable arm cuff.

Why: To find out if you have high blood pressure (also called hyper-tension) or
prehypertension . Both are risk factors for heart disease.

When: At least every 2 years, or more often if you have high blood pressure
prehypertension.
 Fasting Plasma Glucose
What: The preferred test for diagnosing diabetes. After you have fasted
overnight, you will be given a blood test the following morning.
Why: To find out if you have diabetes or are likely to develop the disease.
Fasting plasma glucose levels of 126 mg/dL or higher in two tests on different
days mean that you have diabetes. Levels between 100 and 125 mg/dL mean
that you have an increased risk of developing diabetes and may have
prediabetes. Diabetes is an important risk factor for heart disease and other
medical disorders.
When: At least every 3 years, beginning at age 45. If you have risk factors for
diabetes, you should be tested at a younger age and more often.
SUMMARY
Prevention of first heart attacks and strokes, individual health-care
interventions need to be targeted to those at high total cardiovascular risk or those
with single risk factor levels above traditional thresholds, such as hypertension and
hypercholesterolemia. The former approach is more cost-effective than the latter 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. In addition costly surgical operations are sometimes required to treat CVDs.
Medical devices are required to treat some CVDs. Such devices include
pacemakers, prosthetic valves, and patches for closing holes in the heart.

Substance Use and Abuse
Objectives:
 Address addiction and risk factor for addiction

 Define types of drugs, possible health effects and
treatment options
 Assess personal risk for substance use and abuse
Drug Abuse and Addiction
Substance abuse refers to the harmful or hazardous use of psychoactive

substances, including alcohol and illicit drugs. Psychoactive substance use can lead
to dependence syndrome - a cluster of behavioral, cognitive, and physiological
phenomena that develop after repeated substance use and that typically include a
strong desire to take the drug, difficulties in controlling its use, persisting in its use
despite harmful consequences, a higher priority given to drug use than to other
activities and obligations, increased tolerance, and sometimes a physical withdrawal
state.
Policies which influence the levels and patterns of substance use and related
harm can significantly reduce the public health problems attributable to substance
use, and interventions at the health care system level can work towards the
restoration of health in affected individuals.
Substance abuse can simply be defined as a pattern of harmful use of any

substance for mood-altering purposes. "Substances" can include alcohol and other
drugs (illegal or not) as well as some substances that are not drugs at all.

"Abuse" can result because you are using a substance in a way that is not
intended or recommended, or because you are using more than prescribed. To be
clear, someone can use substances and not be addicted or even have a substance
use disorder, as defined in the Diagnostic and Statistical Manual, Fifth Edition.
What is drug addiction?
Addiction is defined as a chronic, relapsing

brain disease that is characterized by
compulsive drug seeking and use, despite
harmful consequences. It is considered a
brain disease because drugs change the
brain by changing its structure and how it
works. These brain changes can be long-
lasting and can lead to the harmful behaviors
seen in people who abuse drugs.
Addiction is defined as a chronic, relapsing brain disease that a characterized

by compulsive drug seeking and use, despite harmful consequences. It is
considered a brain disease because drugs change the brain by changing its
structure and how it works. These brain changes can be long-lasting and can
lead to the harmful behaviors seen in people who abuse drugs.
Addiction is a lot like other diseases, such as heart disease. Both disrupt the
normal, healthy functioning of the underlying organ, have serious harmful
consequences, and are preventable and treatable, but if left untreated, can las a
lifetime.
Why do people use drugs?
In general, people begin taking drugs for a variety reasons:
 To feel good
Most abused drugs produce intense

feelings of pleasure. This initial sensation
of euphoria is followed by other effects,
which differ depending on the type of drug
used. For example, with stimulants such
as cocaine, the “high” is followed by
feelings of power, self -confidence and
increased energy. In contrast, the euphoria

caused by opiates, such as heroin, is followed by feeling of relaxation and

satisfaction.
 To feel better
Some people who suffer from social anxiety, stress-related disorder and
depression begin abusing drugs in an attempt to lessen feelings of distress.
Stress can play a major role in initial drug use, continuing drug abuse, or else
relapse in patients recovering from addiction.
 To do better
Some people feel pressure to chemically enhances or improve their cognitive

or athletic performance, which can play a role in initial experimentation and
continued abuse of drugs, such as prescription stimulants or anabolic/androgenic
steroids.
 To satisfy their curiosity and “because others are doing it
In this respect, adolescents are particularly vulnerable because of the strong

influence of peer pressure. Teens are more likely than adults to engage in risky
or daring behaviors to impress their friends and express their independence from
parental and social rules
If taking drugs makes people feel good or better, what’s the problem?
When they first use a drug, people may perceive what seem to be positive
effects. They may also believe that they can control their use. However, drugs can
quickly take over a person’s life. Over time, if drug use continues, other pleasurable
activities become less pleasurable and taking the drug becomes necessary for he
user jus to feel normal. They may then compulsively seek and take drugs even
though doing so causes tremendous problems for themselves and their loved ones.
Some people may start to feel the need to take higher or more frequent doses, even
in the early stages of their drug use. These are the telltale signs of an addiction
Even relatively moderate drug use poses dangers. Consider how a special
drinker can become intoxicated, get behind the wheel of a car, and quickly turn a
pleasurable activity into a tragedy that affects many lives.
Is continued drug abuse a voluntary behavior?
The initial decision to take drugs is typically

voluntary. However, with continued use a person’s
ability to exert self-control can become seriously
impaired; this impairment in self-control is the hallmark
of addiction. Brain imaging studies of people with

addiction show physical changes in areas of the brain that are critical to judgment,
decision making, learning and memory, and behavior control. Scientists believe that
these changes alter the way the brain works and may help explain the compulsive
and destructive behaviors of addiction.
Why do some people become addicted to drugs while others do not?
As with any other disease, vulnerability to addiction differs from person to

person, and no single factor determines whether a person will become addicted to
drugs. In general, the more risk factors a person has, the greater the chance that
taking drugs will lead to abuse and addiction. Protective factors, on the other hand,
reduce a person’s risk of developing addiction. Risk and protective factors may be
either environmental, such as conditions at home, at school, and in the
neighborhood, or biological, for instance, a person’s genes, his or her stage of
development, and even a person’s gender or ethnicity.
What environmental factors increase the risk of addiction?
• Home and family. The influence of the home environment, especially during
childhood, is a very important factor. Children with parents or older family
members who abuse alcohol or drugs or engage in criminal behavior, have an
increased risk of developing their own drug problems.

 Peers and school Friends and acquaintances can have an increasingly strong
influence during adolescence. Drug-using
peers can sway even those without risk factors to try drugs for the first time.
Academic failure or poor social skills can put a child at further risk for using or
becoming addicted to drugs.
What biological factors increase risk of addiction?
• Genetics Scientists estimate that genetic factors account for between 40 and 60
percent of a person’s vulnerability to addiction. This includes the effects of
environmental factors on the function and expression of a person’s genes. A
person’s stage of development and other medical conditions a person may have are
also factors. Adolescents and people with mental disorders are at greater risk of drug
abuse and addiction than the general population.
• Dramatic changes in brain development that occur during adolescence One of the
brain areas still maturing during adolescence is the prefrontal cortex—the part of the
brain that enables us to assess situations, make sound decisions, and keep our
emotions and desires under control. The fact that this critical part of the adolescent
brain is a work in progress puts teenagers at increased risk for making poor
decisions, such as trying drugs or continuing to take them. Also, introducing drugs
during this period of development may cause brain changes that have profound and
long-lasting consequences.
Assessing Your Personal Risk Factors for Substance Use and Abuse:
Complete one of the following Labs to assess your personal risk factors for
substance use and abuse.
If you drink alcohol complete the following Lab:
1. How does it feel?
If you smoke cigarettes, complete the following Lab:
2. How does it feel?
Terminology Checklist: Addiction: Addiction is defined as a chronic, relapsing

brain disease that is characterized
by compulsive drug seeking and use, despite harmful consequences.

Cocaine: A powerfully addictive stimulant drug made from the leaves of the coca
plant native to South America.
GHB: A depressant approved for use in the treatment of narcolepsy, a disorder

that causes daytime "sleep attacks."
Heroin: An opioid drug made from morphine, a natural substance extracted from
the seed pod of various opium poppy plants.
Inhalants: Solvents, aerosols, and gases found in household products such as

spray paints, markers, glues, and cleaning fluids; also nitrites (e.g., amyl nitrite),
which are prescription medications for chest pain
LSD: A hallucinogen manufactured from lysergic acid, which is found in ergot, a

fungus that grows on rye and other grains.
Marijuana: Marijuana is made from the hemp plant, Cannabis sativa. The main
psychoactive (mind-altering) chemical in marijuana is delta-9-
tetrahydrocannabinol, or THC.
MDMA (Ecstasy / Molly): A synthetic, psychoactive drug that has similarities to

both the stimulant amphetamine and the hallucinogen mescaline.
Methamphetamine: An extremely addictive stimulant amphetamine drug.
BREAK
How was your reading about using substance use and abused? I hope that you will never
use drugs for your own pleasure, it will never help you to overcome your problems.

Test Your Knowledge:
1. Scientists estimate that genetic factors account for between 25-50 percent
of a person’s vulnerability to addiction. T F
2. A standard drink of beer in the US measures 12 ounces T F
3. Loss of smell is a long-term possible health effect of using:

a) GHB b) Heroin c) LSD d) Cocaine
4. List three symptoms that people may experience when withdrawing from
tobacco and nicotine.
Any three of the following choices:
• Anxiety
• Irritability
• Headache
• Hunger
• Cravings for cigarettes and other sources of nicotine
5. List three factors that may influence how a person reacts to alcohol.
Any three of the following choices:
• Race or ethnicity.
• Physical condition (e.g. weight, fitness level).
• Amount of food consumed before drinking.
• How quickly the alcohol was consumed.
• Use of drugs or prescription medicines.
• Family history of alcohol problems
SUMMARY
For many legal substances, the line between use and abuse is not clear. Is
having a couple of drinks every day after work to unwind use or abuse? Is drinking
two pots of coffee in the morning, to get your day started, use or abuse? Is smoking
a pack of cigarettes a day substance abuse? When it comes to illegal substances,
society has determined that its use is harmful and has placed legal prohibitions on its
use. This is to both protect individuals' wellbeing and shield society from the costs
involved with related healthcare resources, lost productivity, the spread of diseases,
crime, and homelessness

Sexually Transmitted Infections
Objective:
 Define STDs, explain how they are transmitted and

identify then most common STDs/STIs
Sexually Transmitted Diseases/Infections (STDs/STIs)
More than 30 different bacteria, viruses and parasites are known to be

transmitted through sexual contact. Eight of these pathogens are linked to the
greatest incidence of sexually transmitted disease. Of these 8 infections, 4 are
currently curable: syphilis, gonorrhea, chlamydia and trichomoniasis. The other 4 are
viral infections which are incurable: hepatitis B, herpes simplex virus (HSV or
herpes), HIV, and human papillomavirus (HPV). Symptoms or disease due to the
incurable viral infections can be reduced or modified through treatment.
STIs are spread predominantly by sexual contact, including vaginal, anal and
oral sex. Some STIs can also be spread through non-sexual means such as via
blood or blood products. Many STIs—including syphilis, hepatitis B, HIV, chlamydia,
gonorrhea, herpes, and HPV—can also be transmitted from mother to child during
pregnancy and childbirth.

A person can have an STI without having obvious symptoms of disease.

Common symptoms of STIs include vaginal discharge, urethral discharge or burning
in men, genital ulcers, and abdominal pain.
What are STDs?
The following information about

STDs is published by the Office of
Disease Prevention and Health
Promotion on the website Healthy
People.gov., and is found on the page
“Sexually Transmitted Diseases”:
STDs refer to more than 25

infectious organisms that are
transmitted primarily through sexual
activity. STD prevention is an essential
primary care strategy for improving reproductive health.1 Despite their burdens,
costs, and complications, and the fact that they are largely preventable, STDs
remain a significant public health problem in the United States. This problem is
largely unrecognized by the public, policymakers, and health care professionals.
STDs cause many harmful, often irreversible, and costly clinical complications, such
as:
• Reproductive health problems

• Fetal and perinatal health problems
• Cancer
• Facilitation of the sexual transmission of HIV infection2
How are STDs Transmitted?
Ejaculation does not have to occur for an

STD/STI to be passed from person to person.
Sharing contaminated needles used to inject
drugs or using contaminated body piercing and
tattooing equipment also can transmit some
infections, such as HIV or hepatitis B and C.
Anyone who has had or is having sexual

intercourse or oral sex, or who has participated
or is participating in sex play, is at risk for
acquiring an STD/STI

Fortunately, it is possible for a person to decrease his or her risk by having

protected sex and knowing his or her STD/STI status and that of his or her partner.
Still, the Centers for Disease Control and Prevention (CDC) estimates nearly 20
million new cases of these reportable STDs/STIs (gonorrhea, chlamydia, syphilis)
occur each year in the United States almost half of them among young people 15 to
24 years of age.1
While not the most common STD/STI, HIV/AIDS is one of the most
devastating and most well known. Recent data from the CDC indicate that 1.1 million
Americans have HIV2:
• One in five is unaware that they have the virus.

• Approximately 50,000 Americans become infected with HIV each year.
• 15,529 people with AIDS died in 2010.
What are the Most Common Types of STIs?
The following information about the most

common STIs is published by the US Department
of Health and Human Services and found on the
NIH’s website on the page “What are some types
of sexually transmitted diseases or sexually
transmitted infections (STDs/STIs)?”:
Approximately 20 different infections are

known to be transmitted through sexual contact.
Here are descriptions of some of the most
common and well known:
Chlamydia
Chlamydia1 (pronounced kla-MID-ee-uh) is a common STD/STI caused by

the bacterium Chlamydia trachomatis. Chlamydia can be
transmitted during vaginal, oral, or anal sexual contact with an infected partner.
While many individuals will not experience symptoms, chlamydia can cause fever,
abdominal pain, and unusual discharge of the penis or vagina.
In women, whether or not they are having symptoms and know about their
infection, chlamydia can cause pelvic inflammatory disease (PID). In PID, the
untreated STD/STI progresses and involves other parts of the woman's reproductive
system, including the uterus and fallopian tubes. This progression can lead to
permanent damage to the woman's reproductive organs. This damage may lead to
ectopic pregnancy (in which the fetus develops in abnormal places outside of the
womb, a condition that can be life threatening) and infertility.

Additionally, if the woman is pregnant, her developing fetus is at risk, because

chlamydia can be passed on during her pregnancy or delivery and could lead to eye
infections or pneumonia in the infant. If chlamydia is detected early, it can be treated
easily with an antibiotic taken by mouth.
Gonorrhea
Gonorrhea (pronounced gon-uh-REE-uh) is caused by the bacterium

Neisseria gonorrhoeae, which can grow rapidly and multiply easily in the warm,
moist areas of the reproductive tract. The most common symptoms of gonorrheal
infection are a discharge from the vagina or penis and painful or difficult urination.
As with chlamydial infection, the most common and serious complications of

gonorrhea occur in women and include
pelvic inflammatory disease (PID), ectopic pregnancy, infertility, and the potential
spread to the developing fetus if acquired during pregnancy. Gonorrhea also can
infect the mouth, throat, eyes, and rectum and can spread to the blood and joints,
where it can become a life-threatening illness.
In addition, people with gonorrhea can more easily contract HIV, the virus that
causes AIDS. HIV-infected people with gonorrhea are also more likely to transmit the
virus to someone else.3
Genital Herpes
Genital herpes4 is a contagious infection caused by the herpes simplex virus

(HSV). There are two different strains, or types, of HSV: herpes simplex virus type 1
(HSV-1) and type 2 (HSV-2). Both can cause genital herpes, although most cases of
genital herpes are caused by HSV-2.5 When symptomatic, HSV-1 usually appears
as fever blisters or cold sores on the lips, but it can also infect the genital region
through oral-genital or genital-genital contact. Symptomatic HSV-2 typically causes
painful, watery skin blisters on or around the genitals or anus. However, substantial
numbers of people who carry these viruses have no or only minimal signs or
symptoms. Neither HSV-1 nor HSV-2 can be cured, and even during times when an
infected person has no symptoms, the virus can be found in the body's nerve cells.
Periodically, some people will experience outbreaks in which new blisters form on
the skin in the genital area; at those times, the virus is more likely to be passed on to
other people. Pregnant women, especially those who acquire genital herpes for the
first time
during pregnancy, may pass the infection to their newborns, causing life-threatening
neonatal HSV, an infection affecting the infant's skin, brain, and other organs.6

HIV/AIDS
HIV, or the human immunodeficiency virus,7 is the virus that causes AIDS
(acquired immunodeficiency syndrome). HIV destroys the body's immune system by
killing the blood cells that fight infection. Once HIV destroys a substantial proportion
of these cells, the body's ability to fight off and recover from infections is
compromised. This advanced stage of HIV infection is known as AIDS.
People whose HIV has progressed to AIDS are very susceptible to

opportunistic infections that do not normally make people sick and to certain forms of
cancer. AIDS can be prevented by early initiation of antiretroviral therapy in those
with HIV infection. Transmission of the virus primarily occurs during unprotected
sexual activity and by sharing needles used to inject intravenous drugs, although the
virus also can spread from mother to infant during pregnancy, delivery, and
breastfeeding.
In 2013, NIH-supported researchers reported that a 2-year-old child who was

born with HIV and was treated starting in the first few days of life has had her HIV
infection go into remission. This appears to be the first case of functional cure of HIV.
Human Papillomavirus (HPV)
HPV8 is the most common STD/STI. More than 40 HPV types exist, and all of
them can infect both men and women. The types of HPVs vary in their ability to
cause genital warts; infect other regions of the body, including the mouth and throat;
and cause cancers of the cervix, vulva, penis, and mouth.
Although no cure exists for HPV infection once it occurs, regular screening
with a Pap smear test can prevent or detect at an early stage most cases of HPV-
caused cervical cancer. (A Pap smear test involves a health care provider taking
samples of cells from the cervix during a standard gynecologic exam; these cells are
examined under a microscope for signs of developing cancer). A newly available
vaccine protects against most (but not all) HPV types that cause cervical cancer. The
American Academy of Pediatrics recommends this vaccine for school-aged boys and
girls.9
Syphilis
Syphilis10 infections, caused by the bacterium Treponema pallidum, are

passed from person to person during vaginal, anal, or oral sex through direct contact
with sores, called chancres. Between 2001 and 2009, the Centers for Disease
Control and Prevention (CDC) data show that the syphilis rate increased each year.
Those people at highest risk for syphilis include men having sex with both men and
women and people residing in the south.10 The first sign of syphilis is a chancre, a
painless genital sore that most often appears on the penis or in and around the

vagina. Beyond being the first sign of a syphilis infection, chancres make a person
two to five times more likely to contract an HIV infection. If the person is already
infected with HIV, chancres also increase the likelihood that the virus will be passed
on to a sexual partner.3 These sores typically resolve on their own, even without
treatment. However, the body does not clear the infection on its own, and, over time,
syphilis may involve other organs, including the skin, heart, blood vessels, liver,
bones, and joints in secondary syphilis. If the illness is still not treated, tertiary
syphilis can develop over a period of years and involve the nerves, eyes, and brain
and can potentially cause death.
Expectant mothers harboring the bacterium are at an increased risk of

miscarriage and stillbirth, and they can pass the infection on to their fetuses during
pregnancy and delivery. Infants that acquire congenital syphilis during pregnancy
may suffer from skeletal deformity, difficulty with speech and motor development,
seizure, anemia, liver disease, and neurologic problems.
Bacterial Vaginosis
Bacterial vaginosis11 is a common, possibly sexually transmitted, vaginal

infection in women of reproductive age. While it is healthy and normal for a vagina to
have bacteria, just like the skin, mouth, or gastrointestinal (GI) tract, sometimes
changes in the balance of different types of bacteria can cause problems.
Bacterial vaginosis occurs when problematic bacteria that are normally

present only in small amounts increase in number, replace normal vaginal lactobacilli
bacteria, and upset the usual balance. This situation becomes more likely if a woman
douches frequently or has new or multiple sexual partners. The most common sign
of a bacterial vaginosis infection is a thin, milky discharge that is often described as
having a "fishy" odor. However, some women will have no symptoms at all.
Regardless of symptoms, having bacterial vaginosis increases the risk of getting
other STDs/STIs and is also associated with pelvic inflammatory disease (PID), an
infection of the female reproductive organs, including the uterus and the fallopian
tubes (which carry eggs to the uterus), and postoperative infections. Preterm labor
and birth are also possibly more common in women with bacterial vaginosis.
Trichomoniasis
Trichomoniasis12 (pronounced trik-uh-muhNAHY-uh-sis) infection is caused

by the single-celled protozoan parasite Trichomonas vaginalis and is common in
young, sexually active women. The parasite also infects men, though less frequently.
The parasite can be transmitted between men and women as well as between
women whenever physical contact occurs between the genital areas. Although
Trichomonas infections do not always cause symptoms, they can cause frequent,
painful, or burning urination in men and women as well as vaginal discharge, genital
soreness, redness, or itching in women. Because the infection can occur without

symptoms, a person may be unaware that he or she is infected and continue to

reinfect a sexual partner who is having recurrent signs of infection. As with bacterial
STDs/STIs, all sexual partners should be treated at the same time to avoid re-
infection.
NICHD-sponsored research has shown that during pregnancy, Trichomonas

infection is associated with an increased risk of premature birth and infants with low
birth weight. Moreover, infants born to mothers with Trichomonas infection are more
than twice as likely as infants born to uninfected women to be stillborn or to die as
newborns.13
Viral Hepatitis
Viral hepatitis is a serious liver disease that can be caused by several

different viruses, which can be transmitted through sexual contact.
• Hepatitis A virus (HAV) causes a short-term or self-limited liver infection that can
be quite serious, although it does not result in chronic infection. While there are other
ways the virus can be transmitted, HAV can be spread from person to person during
sexual activity through oral-rectal contact. Vaccination can prevent HAV infection.13
• Hepatitis B virus (HBV) causes a serious liver disease that can result in both
immediate illness and lifelong infection leading to permanent liver scarring
(cirrhosis), cancer, liver failure, and death. HBV spreads through both heterosexual
and homosexual contact as well as through contact with other bodily fluids, such as
blood, through shared contaminated needles used for injecting intravenous (IV)
drugs, tattooing, and piercing. Pregnant women with HBV can transmit the
virus to their infants during delivery. HBV infection is preventable through
vaccination.1
• Hepatitis C virus (HCV) can cause an immediate illness affecting the liver, but it
more commonly becomes a silent, chronic infection that leads to liver scarring
(cirrhosis), cancer, liver failure, and death. HCV is most commonly transmitted
through sharing needles or exposure to infected blood. However, it can spread
through sexual contact or from mother to fetus during pregnancy and delivery. There
is no vaccine for HCV, and treatments are not always effective.
How You Can Prevent STDs
STI Treatment Options:
The following information about the

most common STIs is published by the US
Department of Health and Human Services
and found on the NIH’s website on the page

“What are the treatments for sexually transmitted diseases and sexually transmitted
infections (STDs/STIs)?”:
STDs/STIs caused by bacteria, yeast, or parasites can be treated with

antibiotics. These antibiotics are most often given by mouth (orally). However,
sometimes they are injected or applied directly to the affected area. Whatever the
infection, and regardless of how quickly the symptoms resolve after beginning
treatment, the infected person must take all of the medicine prescribed by the health
care provider to ensure that the STD/STI is completely treated.
Although treatments, complications, and

outcomes vary among viral STDs/STIs
depending on the particular virus (HIV,
genital herpes, human papillomavirus,
hepatitis, or cytomegalovirus), health care
providers can provide treatments to reduce
the symptoms and the progression of most of
these illnesses. For example, medications
are available to limit the frequency and
severity of genital herpes outbreaks while
reducing the risk that the virus will be passed
on to other people.
Individuals with HIV need to take special antiretroviral drugs that control the
amount of virus they carry. These drugs, called highly active antiretroviral therapy, or
HAART,1 can help people live longer, healthier lives. If a woman with HIV becomes
pregnant, these medicines also can reduce the chance that her fetus or infant will get
the infection. Being tested and treated for STDs/STIs is especially important for
pregnant women because some STDs/STIs may be passed on to their infants during
pregnancy or delivery. Testing women for these STDs/STIs early in their pregnancy
is important, so that steps can be taken to help ensure delivery of a healthy infant.
The necessary treatment will depend on the type of STD/STI involved.
Test Your Knowledge:
1. AIDS is always the end result for people with HIV. T F
2. There will always be symptoms present if a person has an STD. T F

3. ___________ can develop over a period of years and involve the nerves, eyes,
and brain and can potentially cause death.
a) Tertiary syphilis b) HIV c) Human Papillomavirus (HPV) d) Hepatitis C
virus (HCV)
4. List 3 clinical complications of STDs.
5. List 3 ways that you can prevent STDs.

SUMMARY
Despite considerable efforts to identify simple interventions that can reduce

risky sexual behavior. Behavior change remains a complex challenge. Research has
demonstrated the need to focus on carefully defined populations, consult extensively
with the identified target populations, and involve them in design, implementation
and evaluation. Syndromic management is simple, assures rapid, same-day
treatment, and avoids expensive or unavailable diagnostic tests for patients that
present with symptoms. This approach results to overtreatment and missed
treatment as majority of STIs are asymptomatic. Thus, in addition to syndromic
management, screening strategies are essential. To interrupt transmission of
infection and prevent re-infection, treating sexual partners is an important component
of STI case management.
References
Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al.

Global and Regional Estimates of the Prevalence and Incidence of Four Curable
Sexually Transmitted Infections in 2016. WHO Bulletin. June
2019. https://www.who.int/bulletin/online_first/BLT.18.228486.pdfReport on global
sexually transmitted infection surveillance, 2018. Geneva: World Health
Organization; 2018. Licence: CC BY-NC-SA 3.0
IGO] https://www.who.int/reproductivehealth/publications/stis-surveillance-2018/en/
National Institute on Drug Abuse National Institutes of Health U.S. Department of

Health and Human Services
(https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/
preface)
(https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts)
Centers for Disease Control and Prevention. (2012, February 8). Chlamydia-CDC
Fact Sheet. Retrieved July 11, 2012, from
http://www.cdc.gov/std/chlamydia/STDFactChlamydia.htm 2. Centers for Disease
Control and Prevention. (2012, June 4). Gonorrhea-CDC Fact Sheet. Retrieved July
11, 2012, from http://www.cdc.gov/std/gonorrhea/STDFactgonorrhea.htm 3. Centers
for Disease Control and Prevention. (2012, April 11). Basic Information about HIV
and AIDS. Retrieved July 11, 2012, from http://www.cdc.gov/hiv/basics/index.html 4

Congratulations you have just finished all the modules under Fitness and Wellness. It was
an amazing experience knowing your health and wellness status. I hope that you will
continue your good performance. Job well done!

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Fitness and Wellness | Module 5

UEP- PE Department | PE 1 (Fitness and Wellness) 1

There are also a number of underlying determinants of CVDs or "the causes

What is Cardiovascular disease?

Cardiovascular disease (CVD) generally refers to conditions that involved

Heart disease is disorder of blood vessels that can

Other types of heart disease include:

 Coronary artery disease, damage or disease

UEP- PE Department | PE 1 (Fitness and Wellness) 2

 Peripheral artery disease: A circulatory condition in which narrowed blood

Strokes are the fifth leading cause of

A stroke that occurs as the result of a blockage is called an ischemic stroke. A

The Cincinnati Stroke Scale provides early warning signs of a stroke:

 F= Face: Is one side of the face drooping down?

What Causes CVD?

The conditions listed below, all of

UEP- PE Department | PE 1 (Fitness and Wellness) 3

African Americans have the highest risk factor for CVD.

UEP- PE Department | PE 1 (Fitness and Wellness) 4

This condition is viewed as seriously as any of the other factors, such as

Personal Risk Assessment

What Is Your Number?

What: A simple, painless test using an inflatable arm cuff.

UEP- PE Department | PE 1 (Fitness and Wellness) 5

 Fasting Plasma Glucose

UEP- PE Department | PE 1 (Fitness and Wellness) 6

Substance Use and Abuse

 Address addiction and risk factor for addiction

Drug Abuse and Addiction

Substance abuse refers to the harmful or hazardous use of psychoactive

Substance abuse can simply be defined as a pattern of harmful use of any

UEP- PE Department | PE 1 (Fitness and Wellness) 7

What is drug addiction?

Addiction is defined as a chronic, relapsing

Addiction is defined as a chronic, relapsing brain disease that a characterized

Why do people use drugs?

In general, people begin taking drugs for a variety reasons:

Most abused drugs produce intense

UEP- PE Department | PE 1 (Fitness and Wellness) 8

caused by opiates, such as heroin, is followed by feeling of relaxation and

Some people feel pressure to chemically enhances or improve their cognitive

 To satisfy their curiosity and “because others are doing it

In this respect, adolescents are particularly vulnerable because of the strong

Is continued drug abuse a voluntary behavior?

The initial decision to take drugs is typically

UEP- PE Department | PE 1 (Fitness and Wellness) 9

Why do some people become addicted to drugs while others do not?

As with any other disease, vulnerability to addiction differs from person to

What environmental factors increase the risk of addiction?

UEP- PE Department | PE 1 (Fitness and Wellness) 10

If you drink alcohol complete the following Lab:

1. How does it feel?

If you smoke cigarettes, complete the following Lab:

2. How does it feel?

Terminology Checklist: Addiction: Addiction is defined as a chronic, relapsing

UEP- PE Department | PE 1 (Fitness and Wellness) 11

GHB: A depressant approved for use in the treatment of narcolepsy, a disorder

Inhalants: Solvents, aerosols, and gases found in household products such as

LSD: A hallucinogen manufactured from lysergic acid, which is found in ergot, a

MDMA (Ecstasy / Molly): A synthetic, psychoactive drug that has similarities to