Controlling hypertension

Cardiovascular disease (CVD), which includes heart disease and stroke, is the leading cause of death in the country, according to the Department of Health (DoH).

One of the major contributing factors of CVD is hypertension or elevated blood pressure. The World Health Organization (WHO) said that hypertension is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases. Other important CVD risk factors are smoking, high cholesterol, diabetes, physical inactivity or sedentary lifestyle, being overweight or obese, and family history of CVD.

The prevalence of hypertension in the country has been progressively increasing, a key finding of the latest Philippine Heart Association (PHA) Study on Hypertension or PRESYON 4. From 11% in 1992, hypertension prevalence among Filipinos ballooned to 37% in 2021.

“Awareness on hypertension, treatment, compliance, and blood pressure control rates in the country have been low over the years. Fifty-eight percent of Filipinos with hypertension have end organ damage, which is damage in major organs such as the heart, kidneys, brain, and eyes due to uncontrolled hypertension. Hypertensionrelated stroke is the most common cause of death in hospitalized patients,” said PHA past president Dr. Jorge A. Sison, who presented the results of Presyon 4, a nationwide hypertension survey, in 2021.

Conducted in 13 regions from January 2021 to April 2021, Presyon 4 involved almost 2,800 individuals aged 12 years and older. Ilocos had the highest hypertension prevalence (51%) followed by Western Visayas (43%), Cagayan Valley (42%), Central Visayas (41%), and Metro Manila (40%). Hypertension was most prevalent in the 70-79 age group (78%) followed by 80 and up (73%), 60-69 (69%), 50-59 (60%), and 40-49 (51%).

Hypertension prevalence was slightly higher in urban areas (51%) than in rural areas (49%). Hypertension has the highest prevalence among Filipino adults in socioeconomic class Broad C (41%) followed by AB/C+ and E (both 37%), with D (36%) trailing closely. Widows and widowers had the highest hypertension prevalence (62%) followed by separated (56%) and married individuals (44%).

Sixty-seven percent of adult respondents were on antihypertensive medication, but 61% of them had uncontrolled hypertension. Combining respondents with and without medications, only 36% had controlled hypertension. Sixty-seven percent were taking angiotensin receptor blockers while 41% were on calcium channel blockers. The majority of respondents (78%) were taking one antihypertensive medication; 18% were on two medications and 2% were taking three medications for hypertension. Only 1% of respondents were on four medications and fixed-dose combinations.

Treatment compliance rate was a high 87%. Among compliant respondents, 40% had controlled hypertension compared to 32% among those who were noncompliant. Almost half of respondents (45%) had their blood pressure checked in a health center, 25% at home, 17% in a clinic, and 8% in a hospital. There were more overweight and obese adult and adolescent hypertensives compared to their non-hypertensive counterparts.

The country observes National Hypertension Awareness Month this May, and information about the condition could help in good heart health. The DoH is reminding everyone to check their blood pressure regularly as hypertension is also called a “silent killer.”

The WHO said that some symptoms, should they occur, include early morning headaches, nosebleeds, irregular heart rhythm, vision changes, and buzzing in the ears. Severe symptoms, meanwhile, can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain and muscle tremors.

If the blood pressure is 140/90 mmHg or higher, it is important to consult a doctor for appropriate diagnosis and treatment. If prescribed with medication, take it as directed by the doctor.

Another way to care for the heart is to eat a healthy diet rich in fruits and vegetables, and low in sodium (less than 5 grams daily). It will also be helpful to achieve and maintain a healthy body weight. Engage in at least 30 minutes of moderate and age-appropriate physical activity on most days of the week.

Smoking is a modifiable risk factor for hypertension, and thus, it will be important to quit and avoid secondhand smoke. Working on reducing and managing stress are also effective ways of preventing or controlling hypertension.

TEODORO B. PADILLA is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP), which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.