Dr. Sibulo delivers lecture at ASEAN cardiology confab on region’s trends of heart failures

(Here are relevant data and timely information from Dr. Antonio S. Sibulo Jr.’s lecture at the 23rd Congress of the ASEAN Federation of Cardiology held in Bangkok, Thailand, Sept. 28-Oct. 1, 2018)

HEART failure (HF) has an estimated global prevalence ofapproximately 27 million occurrences, and is the leading cause of morbidity and deaths. It is considered a major health burden.

In the Asia-Pacific region, it is associated with significant socioeconomic impediment, representing a major cause of hospital admissions, loss of work and productivity, and death.

However, reliable data in our region is lacking. An accurate account of HF is needed in order to address community-wide strategies to influence short and long-term clinical outcomes.

Demographically, HF patients in the ASEAN are much younger compared to Western countries. The average age in Western countries is about 75 years ,while in the Asia Pacific it is 67 years. In the Philippines, it is 53 years.

Country-to-country differences are noted in terms of how HF is managed.

That may depend on several factors, namely: Racial and genetic differences, nutritional as well as anthropometric factors, availability of drugs and devices, economic considerations in terms of access to care, and differences in who takes care of patients (cardiologists, internists or primary care).

The ASEAN Federation of Cardiology (AFC) was formed in 1973 and is now composed of 10 countries. It had its first congress in 1975. In 1986, it established the Sukaman Memorial Lecture in order to recognize and honor outstanding cardiologists who have dedicated service, work, and contribution for the advancement of ASEAN cardiology.

In the past, there have been only two Filipino cardiologists honored to give this lecture. They were, Dr.Yolando Sulit (9th AFCC 1992) and Dr. Homobono Calleja (14th AFCC 2002).

The 23rd AFCC was held this year in Bangkok, Thailand, Sept. 28-Oct 1, 2018. Dr. Antonio S. Sibulo Jr. was honored to deliver this prestigious lecture entitled, “ASEAN Heart Failure: Current Practices and Trends.” He emphasized that it is important to identify HF risk factors to reduce the risk of developing the disease.

The prevalence of hypertension in Asia is more than 24 percent in Cambodia and Laos, compared with UK (15.2 percent) and USA (13.4 percent). In the Philippines, it is 22 percent.

There is lower prevalence of obesity in Asia which ranges from 16.4 percent to 47.8 percent. The Philippines has an obesity prevalence of 22 percent. Diabetes is a notable risk factor with high prevalence in Brunei, Malaysia, Singapore, and Thailand, with 9-11 percent. In the Philippines, DM prevalence is 6 percent.

The very high prevalence for smoking in the ASEAN is a concern (Indonesia 36.5 percent), compared to UK and USA with just 18-19 percent. In the Philippines, smoking rate is 27 percent. Physical inactivity is highest in Malaysia at 51.6 percent which may contribute to high premature mortality in the ASEAN. The Philippine inactivity rate is 14 percent. Recommendations: 1. Enhance more cooperation between ASEAN countries to establish a more definitive prevalence in the region.

2. Identify and address inherent risk factors to curb the rise of the disease burden.

3. Increase campaign in the community on the awareness of HF through lay and medical education in the identification and management of the failing heart.

4. Establish HF clinics to propagate GDMT optimum care

5. Make available disease modifying drugs to the bigger segment of the population who need it.

6. ASEAN HF patients do have unique characteristics. We may have to adapt our own management approach accordingly.

Dr. Sibulo is currently head of the Department of Exercise Testing at St. Luke’s Medical Center (SLMC). He is a member of the board of directors of the Heart Failure Society of the Philippines, and member of the Executive Committee of the HB Calleja Heart and Vascular Institute of SLMC.