Health promotion or pharmacological treatment for chronic diseases?


Over the last years medicine has progressed very rapidly. Com- municable diseases, which were the leading causes of mortali- ties, are not anymore, especially in developed countries. Cur- rently, non-communicable diseases are more prevalent, and most of them are related to changes in our daily habits and degenerative processes. Most of these diseases are chronic, need continuous care and treatment with limited improvement and high costs. The General Assembly of the United Nations in its resolution 65/238 recognized the primary role and responsibility of Governments in responding to the challenge of non- communicable diseases and the essential need for the efforts and engagement of all sectors of society to generate an effec- tive response. Special emphasis has been concentrated on phar- macological treatments for most of chronic non-communicable diseases with the challenge to discover new drugs for treating, in most cases, chronic irreversible degenerative diseases asso- ciated with aging. Little care was given to non-pharmacological lines of treatment.


Mathers CD, Boerma T, Ma Fat D. Global and regional causes of death. Br Med Bull 2009;92(1):7-32. Available from: PubMed PMID: 19776034. doi: 10.1093/bmb/ldp028. [Google Scholar]

Alwan A, Maclean DR, Riley LM, et al. Monitoring and surveillance of chronic non-communicable diseases: pro- gress and capacity in high-burden countries. Lancet 2010;376(9755):1861-8. Available from: doi: 10.1016/S0140-6736(10)61853-3. [Google Scholar]

Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA 2010;303(20):2043-50. Available from: doi: 10.1001/jama.2010.650. [Google Scholar]

Germino FW. The management and treatment of hypertension. Clin Cornerstone 2009;9(Suppl 3):3-27. [Google Scholar]

Heran BS, Wong MM, Heran IK, Wright JM. Blood pressure lowering efficacy of angiotensin converting enzyme (ACE) inhibitors for primary hypertension.. Cochrane Database Syst Rev 2008 Oct;4(4). Available from: PubMed PMID: 18843651. doi: 10.1002/14651858.CD003823.pub2. [Google Scholar]

Wright JM, Musini VM. First-line drugs for hypertension.. Cochrane Database Syst Rev 2009 Jul;3(3). Available from: PubMed PMID: 19588327. doi: 10.1002/14651858.CD001841.pub2. [Google Scholar]

Gee ME, Bienek A, Campbell NRC, Bancej CM, Robitaille C, Kaczorowski J, et al. Prevalence of, and Barriers to, Preventive Lifestyle Behaviors in Hypertension (from a National Survey of Canadians With Hypertension. Am J Cardiol 2012;109(4):570-575. Available from: PubMed PMID: 22154320. doi: 10.1016/j.amjcard.2011.09.051. [Google Scholar]

Fagard RH. Exercise therapy in hypertensive cardiovascular disease. Prog Cardiovasc Dis 2011;53(6):404-411. Available from: PubMed PMID: 21545926. doi: 10.1016/j.pcad.2011.03.006. [Google Scholar]

McGrane MM, Essery E, Obbagy J, et al. Dairy consump- tion, blood pressure, and risk of hypertension: an evidence- based review of recent literature. Curr Cardiovasc Risk Rep 2011;5(4):287-98. Available from: doi: 10.1007/s12170-011-0181-5. [Google Scholar]

Jürgens G, Graudal NA. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride.. Cochrane Database Syst Rev 2004;1(1). Available from: PubMed PMID: 14974053. doi: 10.1002/14651858.CD004022.pub2. [Google Scholar]

Khan NA, Hemmelgarn B, Herman RJ, et al. The 2008 Canadi- an Hypertension Education Program recommendations for the management of hypertension: part 2 - therapy. Can J Cardiol 2008;24(6):465-75. Available from: doi: 10.1016/S0828-282X(08)70620-2. [Google Scholar]

Norris SL, Zhang X, Avenell A, et al. Long-term non-pharma- cological weight loss interventions for adults with prediabetes. Cochrane Database Syst Rev 2005;2. [Google Scholar]

Ginter E, Simko V. Diabetes type 2 pandemic in 21st century.. Bratisl Lek Listy 2010;111(3):134-137. Available from: PubMed PMID: 20437822. [Google Scholar]

Juurlink DN, Gomes T, Lipscombe LL, et al. Adverse car- diovascular events during treatment with pioglitazone and rosiglitazone: population based cohort study. BMJ 2009;339. [Google Scholar]

Hahr AJ, Molitch ME. Optimizing insulin therapy in patients with type 1 and type 2 diabetes mellitus: optimal dosing and timing in the outpatient setting.. Dis Mon 2010;56(3):148-162. Available from: PubMed PMID: 20189500. doi: 10.1016/j.disamonth.2009.12.009. [Google Scholar]

Nield L, Summerbell CD, Hooper L, Whittaker V, Moore H. Dietary advice for the prevention of type 2 diabetes mellitus in adults.. Cochrane Database Syst Rev 2008 Jul;3(3). Available from: PubMed PMID: 18646120. doi: 10.1002/14651858.CD005102.pub2. [Google Scholar]

Dubnov-Raz G, Berry EM. The dietary treatment of obesity.. Med Clin North Am 2011;95(5):939-952. Available from: PubMed PMID: 21855701. doi: 10.1016/j.mcna.2011.06.006. [Google Scholar]

Tavares A, Viveiros F, Cidade C, et al. Bariatric surgery: epidemic of the XXI Century [Article in Portuguese. Acta Med Port 2011;24(1):111-116. Available from: PubMed PMID: 21672448. [Google Scholar]

Abdool-Gaffar MS, Ambaram A, Ainslie GM, et al. Guideline for the management of chronic obstructive pulmonary disease - 2011 update. S Afr Med J 2011;101(1 Pt 2):63-73. Available from: PubMed PMID: 21526617. [Google Scholar]

Singh S, Loke YK, Enright PL, et al. Mortality associated with tiotropium mist inhaler in patients with chronic obstructive pul- monary disease: systematic review and meta-analysis of ran- domised controlled trials. BMJ 2011;342. [Google Scholar]

Sanfélix-Gimeno G, Peiró S, Meneu R. Pharmaceutical pre- scription in primary care. SESPAS report 2012 [Article in Spanish. Gac Sanit 2012;26(Suppl 1):41-5. Available from: doi: 10.1016/j.gaceta.2011.09.015. [Google Scholar]

Vogt-Ferrier N. Older patients, multiple comorbidities, poly- medication … should we treat everything. Eur Ger Med 2011;2(1):48-51. Available from: doi: 10.1016/j.eurger.2010.11.011. [Google Scholar]

Mirosevic Skvrce N, , Macolic Sarinic V, , Mucalo I, et al. Adverse drug reactions caused by drug-drug interactions reported to Croatian Agency for Medicinal Products and Medical Devices: a retrospective observational study. Croat Med J 2011;52(5):604-614. Available from: PubMed PMID: 21990078. doi: 10.3325/cmj.2011.52.604. [Google Scholar]