THE HEART OF THE MATTER
MANILA, NOVEMBER 17, 2008 (TRIBUNE) By Earl D.C. Bracamonte, Contributor - Did you know that of the 10.5 million Filipinos with hypertension (or high-blood pressure, in layman’s term), 25 percent are not aware of their condition? As far as treatment is concerned, only 13 percent are controlled or, in the least, kept at normal levels.
The Philippine Heart Association’s (PHA) decision to conduct a survey, simply dubbed “Physician-Related Factors Determining Optimal Blood Pressure Control Among Hypertensive Filipinos,” showed some alarming results.
According to the PHA Council on Hypertension chairman, Dr. Emma Trinidad, the main goal of the study was to identify and evaluate the significant physician-related factors determining blood pressure control among Filipino hypertension sufferers in Metro Manila. “This will be a pilot study and hopefully will progress to become a nationwide survey in the future,” she added.
In her presentation “Gaps in the Management of Hypertension in the Philippines,” during the PHA-Novartis media briefing at the Heart House, Dr. Trinidad pointed out that the burden of cardiovascular diseases as well as prevalence of risk factors for coronary artery disease in the country is rising.
From 1990 to 1997, diseases of the heart and diseases of the vascular system remained to be the first and second leading causes of mortality (death) and morbidity (disability). Hypertension, in particular, has an increasing prevalence of 11 percent in 1992 to 22 percent in 1998, and since then has more or less stabilized at 21 percent in 2007.
Dr. Trinidad also showed that based on the Presyon 2 study, the prevalence of hypertension was 21 percent (717 cases of high blood pressure found in the 3,415 individuals screened). Analyses of the 717 hypertensive subjects showed that only 469 of them (65 percent) were on anti-hypertensive medications with only 65 percent compliant with preventive maintenance. It was also found that the blood pressure control rate was only 20 percent among those on medications, or a very low control rate of only 13 percent of the entire hypertensive population!
PHA director Dr. Eugene Reyes explains that the pilot study, which the PHA is set to embark in partnership with Novartis Healthcare Philippines, aims specifically to describe the health care practices of doctors; determine the significant health practices of doctors that could affect blood pressure control; compare the significant health care practices of doctors both in those with controlled and uncontrolled BP groups; and determine whether the doctor’s approach to blood pressure control is in accordance with the international guidelines stipulated by the Joint National Committee VII (JNC 7) and the World Health Organization (WHO), and local guidelines for management of hypertension.
“To contain a hypertensive condition, one must adopt a lifestyle change. Obese persons must lose weight. Males should weigh 105 lbs at five feet tall and females at a 100 lbs with the same height. To know your ideal weight, simply add six lbs for every inch for males and five lbs for every inch for females. With the resulting figure, give or take (+/-) 10 percent to be in optimum health. Exercise regularly through 30 minutes brisk walking or longer; jogging for half an hour or running a thousand feet or paces; cycling for the same time for resistance building and/or swimming 50-meter laps for an hour with 10 minutes rest in between laps. Swimming is less strenuous because of the buoyancy factor plus your breathing is enhanced. Other water exercises include treading and dripping. Go for a low salt, low fat diet: two grams per day is all the body needs. Too much sodium attracts fluid so you get volume and volume begets pressure.
“For you not to get hypertension, prevent it by having a healthy lifestyle. Have your BP checked regularly. Those with the condition must be fully aware. Detection is the solution. Monitor your blood pressure; take it on a restive state. Rest 5 to 15 minutes after walking. Take medications as prescribed. Regular drug treatment can normalize your blood pressure. Compliance should be a 100 percent. Relapse cases may have your BP rise higher if treatment is stopped. And lastly, stop smoking,” advised Dr. Reyes, a cardiologist and co-chairman of the research committee.
Hypertension is a lifetime condition so taking medications is a lifetime intervention. Don’t stop taking your meds even if your BP has normalized because it may rise again, doctors warn. A regular check-up with your physician is a must. Spread this news to other family members, because if one is hypertensive, most likely another member is.
Factors signaling hypertension include familial or genetic predisposition wherein a parent is hypertensive; high salt diet; a sedentary lifestyle; and smoking, leading to obesity. Teenagers who just watch television (couch potatoes) and those into “finger games” like Nintendo are also at risk.
“Besides aiming to improve the control of hypertension in the country, we also hope that this PHA-initiated study will become an important source of much-needed local data since most of the epidemiological data currently being used by Filipino doctors are based on US or European surveys and studies,” said Dr. Francis Domingo, Novartis Healthcare Philippines chief scientific officer.
“This partnership with the PHA is a step in the right direction towards improving hypertension management in the country,” declared Novartis Healthcare Philippines president and CEO Peter Goldschmidt. As the global leader in hypertension care and provider of the world’s leading anti-hypertensive drug Valsartan, Novartis is committed to helping support PHA, the country’s leading authority on cardiovascular health. “Through this collaborative effort with PHA, we hope the study will help doctors improve the identification and control of high blood pressure in this country and ultimately stop the rising prevalence of this ‘silent killer’ among Filipinos,” Goldschmidt added.
Founded on March 26, 1952, the PHA was established to serve as the country’s nucleus of cardiologic research, training and education, and as a wellspring of essential cardiologic data, as well as for information dissemination and exchange; touching hearts and changing lives along the way.
The PHA is an organization of cardiovascular specialists and lay members that ensures accessible, affordable and quality cardiovascular education and care for every Filipino. By 2012, it hopes to be the leading entity of cardiovascular specialties in the Asia Pacific region in the prevention and management of cardiovascular diseases.
For more information, contact Dr. Emma Trinidad, chair of the PHA Council on Hypertension at the Heart House through telephone number 929-1161.
Chief News Editor: Sol Jose Vanzi
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