H&L interviews cardiologist Dr. Lourdes Ella G. Santos of Cardinal Santos Medical Center (CSMC) about the state of hypertension in the Philippines and how this has been affecting the youth
By Gelyka Ruth R. Dumaraos
High blood pressure or hypertension continues to be a threatening factor to complications such as heart diseases and stroke.
According to the World Health Organization (WHO) and the International Society of Hypertension (ISH), high blood pressure (BP) is the number one attributable cause of mortality worldwide, accounting for about 10 million deaths annually, or about 12.8 percent of the total deaths around the world.
In the Philippines, it has been found out that one out of four Filipinos have hypertension based from the PRESYON survey conducted by the Philippine Heart Association (PHA) in 2013. A similar figure was noted in the National Nutrition Health Survey (NNHeS). Awareness has considerably improved but the control rate—achieving BP less than 140/90 mmHg—remains dismally low, which mirrors the global trend.
According to Dr. Lourdes Ella G. Santos, cardiologist at Cardinal Santos Medical Center (CSMC), the elder population, ranging from 60 to 70 year olds, has a higher risk of developing hypertension. However, the young are not spared. Unhealthy modern diets and lifestyles lead to the increase in prevalence rate of hypertension even among the younger generation.
“We are actually building a nation of hypertensives by virtue of how things are evolving,” she says in an interview, adding that issues should be addressed early.
She notes how the younger generation now lives a relatively unhealthy lifestyle, with smoking, high salt intake, and shifting work schedules as contributing risk factors.
Describing how the youth, with their busy lifestyle, tends to turn to processed foods and instant meals with high salt content, Dr. Santos says the easy access to fast foods and convenience stores offering food products like instant noodles adds to the alarming rise of hypertensives in the country.
Another factor Dr. Santos highlights is the way social media can give stress. She says, “Today, with Facebook and Instagram, you compare yourself to other people every day.”
“As a preventive cardiologist, I do hope we can deal with the rise of hypertension cases among the youth,” Santos adds.
Target organ damage
What’s worrisome about the growing trend of young hypertensives is the looming complication this might bring to their health at an early age.
“Understand that the fear with hypertension is not just a number. It is the effect of high blood pressure on the body—the longer you are exposed to hypertension, the higher the chance that you can get what we call target organ damage.”
There are three vital target organs that can be damaged when hypertension is poorly controlled—eyes, heart, and the kidney.
For the eyes, one can develop hypertensive retinopathy. This can lead to micro bleeds and hemorrhages which can progress and affect eyesight. For this reason, cardiologists advise that people with hypertension also consult their ophthalmologists.
Left ventricular hypertrophy, which is a complication in the heart, can occur if hypertension is not managed well. This may advance to heart failure if not addressed early.
Lastly, hypertension strikes the kidney resulting in hypertensive nephropathy, which may lead to end-stage renal disease with patients requiring dialysis.
“So can you imagine, if instead of developing hypertension at 60 and elevated blood pressure begins at 20, that gives you 40 years of additional exposure to hypertension leading to more side effects.”
The Department of Health (DOH) has launched a program specifically for people with hypertension where they provide free medications. Patients can readily access medications such as metropolol, amlodipine, and losartan in local health centers near them.
This is a big help in alleviating the burdens of the disease, especially among low income families.
“Having free medications that are readily available makes a big difference because the patients will take the medicines if they know they have access to it. If they know that they have access to it and it’s free, then it’s an incentive for them to follow up,” she notes.
Meanwhile, CSMC, conducts its own drive to contribute to lowering risks for people with hypertension. CSMC is one of the institutions which has a training fellowship for cardiology. The fellowship works alongside PHA to conduct several programs not only for residents and fellows but to the general public as well.
Moreover, the fellows and the consultants actively engage in research to be able to diagnose cases early using machines available in the medical center.
The Cardiovascular Department of CSMC provides cardiovascular diagnostic procedures such as treadmill exercise tests using world-class electronic testing equipment and recording devices. These enhance acute detection and early diagnosis of undiagnosed hypertensives.
Apart from other cardio tests and equipment, the department also uses the 24-hour ambulatory blood pressure in hypertension diagnosis. This is currently used in the international setting as a standard for the diagnosis of elevated blood pressure, a machine which is only available in a few centers in the Philippines.
As a cardiologist, Santos calls on the public to learn more about the proper management of blood pressure, to inform themselves and to share this knowledge with others.
“It shouldn’t be just from the physician’s point of view. As lay people, we should be able to do something about hypertension. Even just telling other people about the effects of diet and lifestyle modifications that reduce blood pressure levels is helpful,” she concludes.
“It shouldn’t be just from the physician’s point of view. As lay people, we should be able to do something about it by just telling other people about the effects of unhealthy diet and lifestyle that could actually elevate the blood pressure”
Aug 2018 Health and Lifestyle