Preventing pneumonia and understanding the risk factors are important. This second article in the series on prevention will discuss some diseases that place people at risk for pneumonia. One of the fi rst major disease categories that increases the risk of pneumonia is cardiovascular disease especially congestive heart failure (CHF). The cause for this association may lie in the thought that the fl uid that collects in the air sacs of patient with CHF promotes the growth of aspirated germs. There is also some concern that certain medications used in CHF treatment, especially when used in combination, increase the pneumonia risk. Problems with the endocrine system, most commonly diabetes, can be associated with an increased pneumonia risk. The high blood sugar levels and occasional ketosis which occurs in diabetics alters the immune system Keeping your diabetes under good control can be helpful.

Nervous system diseases especially ones that affect the swallowing mechanism, or that alter the level of a patient’s consciousness, are associated with an increased pneumonia risk. Specifi cally, patients with Parkinson’s often develop discoordinated swallowing function leading to aspiration. The same is true for patients that have had strokes that have affected their voice and ability to swallow. Dental problems, particularly periodontal disease, can put both the elderly and the general population at risk. Studies have shown that regular dental visits reduce the incidence of pneumonia in all age groups. The increase in oral bacteria, which could be aspirated in patients with periodontal disease, is thought to be the cause of the increased risk.