Patient Profile:

Brandon is a 55-year-old African American male that has a family history of cardiovascular
disease; his father passed away from myocardial infarction. He works in a high stress job that
includes 70-hour work weeks and extensive travel to oversee his many work projects.
Furthermore, his schedule does not allow enough time for an extensive exercise program and his
diet consists of fast food, caffeine, and vending machine snacks. He is a smoker and has a
moderate consumption of alcohol.1

Disease Brandon’s Non-Modifiable Risk Brandon’s Modifiable Risk

factors factors
Cardiovascular Disease (include • Family history • High blood pressure
hypertension and stroke) • Age • High cholesterol
• Ethnicity/Race • Smoking
• Gender/Sex • Weight
• Physical activity
• Diet
• Stress
• Triglycerides
Diabetes • Family history • Weight
• Age • Physical activity
• Ethnicity/Race • Diet
• Gender/Sex • High blood pressure
• High cholesterol
• Smoking
• Stress
• Fasting plasma glucose
(FPG)
Cancers Cancer #1 - Cancer #1 -
(Include at least 3 specific types • Family history • Smoking
of cancer Brandon is at risk for • Age • Work
and include specific risk factors • Ethnicity/Race conditions/hazards
for those types of cancer) • Gender/Sex
1. Cancer #1 _Lung Cancer Cancer #2 -
2. Cancer #2 _Colorectal Cancer

1 Case Study Instructions: chrome-extension://bpmcpldpdmajfigpchkicefoigmkfalc/views/app.html

 3. Cancer #3 _Prostate Cancer Cancer #2 - • Weight
• Family history • Physical activity
• Age • Diet
• Ethnicity/Race • Smoking
• Gender/Sex • Alcohol use

Cancer #3 - Cancer #3 -
• Family history • Weight
• Age • Smoking
• Ethnicity/Race • Work
• Gender/Sex conditions/hazards

Risk Assessment:
• Cardiovascular Disease
The following non-modifiable risk factors put Brandon at an increased risk of cardiovascular
disease (including hypertension and stroke): Age; family history; ethnicity/race; and gender/sex.
African Americans are at an increased risk of cardiovascular disease including heart disease,
hypertension, and stroke. African Americans also have the highest prevalence of high blood
pressure in the world. While obesity affects people of all ethnicities and races, African
Americans are disproportionately affected with an obesity rate of 69%. 2
The following modifiable risk factors put Brandon at an increased risk of cardiovascular disease
(including hypertension and stroke): High blood pressure (150 over 90); high cholesterol (LDL
cholesterol 170 mg/dL and HDL cholesterol 40 mg/dL); smoking (half a pack each day); weight;
waist-to-hip ratio (1.8 inches); lack of physical activity; poor diet; stress; and high triglycerides
(240 mg/dL).
Patient Resources:
Family health history- https://www.heart.org/-/media/Files/Health-Topics/General/My-Family-
Health-Tree---Worksheet.pdf
Risk factors for cardiovascular disease- https://www.heart.org/en/health-topics/consumer-
healthcare/what-is-cardiovascular-disease/african-americans-and-heart-disease-stroke

• Diabetes
The following non-modifiable risk factors put Brandon at an increased risk of diabetes: Age;
family history; ethnicity/race; and gender/sex.

2https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/african-americans-and-
heart-disease-stroke
The following modifiable risk factors put Brandon at an increased risk of diabetes: High blood
pressure (150 over 90); high cholesterol (LDL cholesterol 170 mg/dL and HDL cholesterol 40
mg/dL); smoking (half a pack each day); weight; waist-to-hip ratio (1.8 inches); lack of physical
activity; fasting plasma glucose (130 mg/dl); poor diet; stress; and high triglycerides (240
mg/dL).3
According to the American Diabetes Association, a fasting blood sugar greater than or equal to
126 mg/dl signifies that a patient has diabetes. Type 2 diabetes is treatable with modifications
made to diet and exercise; medication including insulin is sometimes needed as part of a
patient’s treatment plan. 4
Patient Resources:
Type 2 Diabetes- https://www.diabetes.org/diabetes/a1c/diagnosis

• Cancer
Upon completion of Brandon’s risk assessment, the patient is at the highest risk for the following
cancers: Lung cancer, colorectal (colon) cancer, and pancreatic cancer.
Lung Cancer
The following non-modifiable risk factors put Brandon at an increased risk of lung cancer: Age;
family history; ethnicity/race; and gender/sex.
The following modifiable risk factors put Brandon at an increased risk of lung cancer: Smoking
(half a pack each day) and work conditions. Working in a factory setting and extensive travel can
increase exposure to asbestos and other cancer-causing substances.5
African American men are more likely than white men to get diagnosed with lung cancer by
12%. Stopping smoking prior to cancer development can allow damaged lung tissue to repair
itself.6
Colon Cancer
The following non-modifiable risk factors put Brandon at an increased risk of colon cancer: Age;
family history; ethnicity/race; and gender/sex.
The following modifiable risk factors put Brandon at an increased risk of colon cancer: Smoking
(half a pack each day); weight; waist-to-hip ratio (1.8 inches); lack of physical activity; poor diet;
stress; and high triglycerides (240 mg/dL). 7

3 Mod4_HE 3500 PowerPoint_Diabetes & COPD_2021.pdf

4 https://www.diabetes.org/diabetes/a1c/diagnosis
5 https://www.cancer.org/cancer/lung-cancer/causes-risks-prevention/risk-factors.html
6 https://www.cancer.org/cancer/lung-cancer/causes-risks-prevention/prevention.html
7 https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html
People aged 45 and over should get regular colon screenings; with screenings, most polyps are
able to be found and removed before they turn cancerous. Smaller polyps that are cancerous are
more easily removed.8
Pancreatic Cancer
The following non-modifiable risk factors put Brandon at an increased risk of pancreatic cancer:
Age; family history; ethnicity/race; and gender/sex.
The following modifiable risk factors put Brandon at an increased risk of pancreatic cancer:
Smoking (half a pack each day); weight; waist-to-hip ratio (1.8 inches); work conditions; and
high triglycerides (240 mg/dL). 9
About 25% of pancreatic cancers are estimated to be caused by smoking and overweight or
obese individuals, especially those who carry extra weight around the waist, are 20% more likely
to be diagnosed with pancreatic cancers. 10
Patient Resources:
Lung Cancer- https://www.cancer.org/cancer/lung-cancer.html
Colon Cancer- https://www.cancer.org/cancer/colon-rectal-cancer.html
Pancreatic Cancer- https://www.cancer.org/cancer/pancreatic-cancer.html

Comprehensive Health Plan:

The following lifestyle recommendations are made with consideration to each area of concern
for the patient as well as the patient’s goals-
• Diet and Nutrition
Key objectives include meal prep, food evaluation, and ordering healthier options at the
drive thru.
Instead of making substantial changes all at once, start with minor changes. One such way to
start making changes to diet is to implement the Reflect, Replace, and Reinforce method. 11

• Make a list of current foods and drinks that are included in everyday diet
• Highlight habits and examine unhealthy eating habits (such as vending machine
snacks and fast food for dinner)
• Plan meals ahead of time
o Set aside one day a week to start prepping one meal for the week
▪ Ex. Meal prep breakfast burritos for the week on Sunday
• Reinforce healthy habits
o Remember that healthy habits take time to form, and setbacks do not mean
failure.

8 https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/prevention.html
9 https://www.cancer.org/cancer/pancreatic-cancer/causes-risks-prevention/risk-factors.html
10 https://www.cancer.org/cancer/pancreatic-cancer/causes-risks-prevention/risk-factors.html
11 https://www.cdc.gov/healthyweight/losing_weight/eating_habits.html
Life gets busy- when someone does not have time to cook at home, changes can be implemented
to make healthier habits on the go.

• Instead of fried foods, opt for foods that are steamed, broiled, baked, roasted,
poached, lightly sautéed, or stir-fried12
• To minimize the effects of alcohol on the body, opt for soothing tea instead of
beer before bed
• Pick foods and drinks without added sugars
o Choose diet or zero sugar soda pop when craving caffeine or something
carbonated; it has zero calories and zero sugar.
Patient Resources:
For a more personalized meal plan, visit https://www.myplate.gov/myplate-plan

• Physical Activity/Exercise
Key objectives include fitting exercise around daily schedule, using exercise to improve
one’s quality of life, utilizing exercises that require little to no equipment.
There are many ways to exercise that do not involve the gym or an extensive workout routine.
Sometimes, even with the best intentions, doing too much at once is a setup for failure. Exercise
can easily fit into one’s everyday life.
Ex. Doing housework or yardwork
One of the best exercises, that is often overlooked, is walking. Walking can help maintain or lose
body weight as well as prevent heart disease and diabetes. Walking is also an excellent way to
improve cardiovascular health, increase energy levels, and reduce stress.13
The Department of Health and Human Services recommends 150 minutes (about 2 and a half
hours) of exercise each week. While this can seem like a high number when looking at it head
on, it realistically equates to just 21 minutes of exercise a day.14 Walking also requires nothing
other than a good pair of shoes which eliminates the need for equipment and the hassle of finding
time to make it to the gym.
If body fat loss is desired, incorporating strength training in addition to walking can help achieve
this. Strength training can include performing exercises such as bench presses or rows, but it can
also be as simple as using one’s own body weight. Squats, lunges, and pushups are all types of
strength training exercises. Strength training should be considered supplemental, again stressing
not to overdo it- strength training can rev up the metabolism and prevent cardiovascular disease. 15
Patient Resources:
Benefits of walking- https://www.hsph.harvard.edu/nutritionsource/walking/

12 https://www.nhlbi.nih.gov/health/educational/wecan/eat-right/eating-out.htm
13 https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/walking/art-20046261
14 https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/walking/art-20046261
15 https://www.livestrong.com/article/352936-the-best-workout-for-men-over-50/
 • Stress Reduction
Key objectives include education about health consequences related to stress and breathing
techniques to manage stress in a productive way.
Stress can have devastating effects on the body, but it is oftentimes unavoidable. It can cause high
blood pressure, heart problems, diabetes, and anxiety.16 Rather than simply eliminate stress, here
are some ways to manage it:
• Exercise- As previously mentioned, exercise is an all-encompassing tool that can be
used to manage weight, improve cardiovascular health, and manage stress.
• Relax muscles- Stretching, taking a hot bath or shower, and a good night’s rest can help
reduce stress levels in the body. 17
• Eating a well-balanced diet can help regulate one’s mood. Avoid skipping meals as this
can increase stress levels.
Deep breathing is a surprisingly effective tool that can reduce stress levels within the body. While
breathing is something people often do without thinking about it, deep breathing can take practice.
The following steps can help improve deep breathing techniques: 18
1. Choose a comfortable spot- this can be anywhere from the bed, the floor, or one’s
favorite chair.
2. Aim to practice deep breathing once or twice a day. The more it is done, the easier it
will be to maintain.
3. Breathe in through the nose, filling the belly with air, and out through the nose. Placing
a hand on the belly will help feel it fill with air and make keeping track of breathing
easier.
4. If silence is uncomfortable, many people find success with guided deep breathing
exercises.
5. Deep breathing takes only a few minutes but can be customized based on preference.
There are many ways to manage stress, the previously mentioned recommendations are not
exhaustive. Work at reducing triggers such as work and make time for yourself. Self-care is
essential for a healthy life. 19
Patient Resources:
Stress management- https://www.helpguide.org/articles/stress/stress-management.htm

16 https://www.webmd.com/balance/stress-management/effects-of-stress-on-your-
body#:~:text=Stress%20can%20play%20a%20part,a%20hazard%20of%20the%20workplace.
17 https://www.webmd.com/balance/guide/tips-to-control-stress
18 https://www.webmd.com/balance/stress-management/stress-relief-breathing-techniques
19 https://www.webmd.com/balance/guide/tips-to-control-stress