Socioeconomic impact and burden of hypertension in the Philippines projected in 2050

Hypertension has remained the number one cause of cardiovascular death in the Philippines for over three (3) decades. Despite this finding, the burden accounted for by hypertension is investigated to a lesser extent. We performed this study to determine the socioeconomic impact of hypertension in the Philippines, and it was projected in the next 30 years. We gathered primary data through interviews, Labor Force Survey (N = 806), and secondary data from various government published reports. The cost of illness (COI) was calculated using the direct morbidity and mortality costs. The impact (% of respondents) of uncontrolled hypertension on productivity at work showed the following; four (4) days missing work (72%) and ten (10) days lost of productivity (63%). The impact (% of respondents) of uncontrolled hypertension on productivity at home showed the following: six (6) days of household suspended (66%), eleven (11) days reduced household work (78%), and five (5) days affected social activity (60%). The productivity loss of premature mortality accounts for 17% of the total economic burden in 2020 and will increase to 20% by 2050. In 2020, 70% of the total economic burden was accounted for direct & indirect care. At its present value, the economic cost of hypertension is expected to increase from US$1 billion in 2020 to US$1.9 billion by 2050. The socioeconomic impact of uncontrolled hypertension in the Philippines was enormous, challenging, and overwhelming for the next 30 years.

Prevalence of atherosclerosis-related risk factors and diseases in the Philippines

BACKGROUND

We conducted a survey in 2008 to measure the prevalence of lifestyle-related diseases and risk factors in Philippine adults.

METHODS

Stratified multistage sampling was used to cover the entire Philippine population of adults aged 20 years or older. Using health questionnaires, anthropometric measurements, and blood examinations, the prevalences of atherosclerosis-related risk factors and diseases were determined. Survey results were compared with those obtained in 2003.

RESULTS

Out of 7700 eligible subjects, 64% to 93.7% responded to different survey items. Age-adjusted hypertension prevalence was 24.6% at a single visit and 20.6% when corrected for true prevalence. The prevalence of diabetes was 3.9% on the basis of fasting blood glucose (FBG), 5.2% by FBG and history, and 6.0% when 2-hour post-load plasma glucose level was determined. The prevalence of dyslipidemia was 72.0% and the prevalence of smoking was 31%. The prevalence of obesity was 4.9% by body mass index (BMI), and 10.2% and 65.6% by waist-hip ratio (WHR) in men and women, respectively. The prevalences of coronary, cerebrovascular, and peripheral arterial diseases were 1.1%, 0.9%, and 1.0%, respectively.

CONCLUSIONS

The prevalences of risk factors for atherosclerosis were higher in 2008 than in 2003, although the increase in diabetes was not significant and smoking decreased. These findings indicate a need for active collaborative intervention by all government agencies and medical societies in the Philippines.

A plump and fatty heart: isolated left ventricular apical hypoplasia

Isolated left ventricular apical hypoplasia is a newly recognized type of cardiomyopathy, with only a few cases reported since it was first described in 2004. We report this case of a 21-year-old Filipino female presenting with unstable supraventricular arrhythmia and heart failure, with characteristic features of isolated left ventricular apical hypoplasia on echocardiography and cardiac magnetic resonance imaging. To our knowledge, this is the first reported adult case in Asia.

A comparison of felodipine and nifedipine as monotherapies for the treatment of mild to moderate hypertension

We conducted a randomised double-blind crossover comparison of felodipine, 10 mg once daily, nifedipine 20 mg twice daily, each treatment being given as a monotherapy for four weeks. Active treatment was preceded by a two-week placebo run-in. Both systolic (SBP) and diastolic (DBP) blood pressures (supine and erect) fell significantly (all P less than 0.001) following both drug treatments. Nifedipine produced a greater orthostatic effect, and hence a significantly greater fall in erect SBP than felodipine (P less than 0.05). There was no significant difference between the effects of the drugs on DBP. Achieved DBP was 90 mmHg or less in 18/22 patients on felodipine and 18/22 patients on nifedipine. Both drugs were well-tolerated. Felodipine given once daily was effective as a monotherapy for the control of mild to moderate hypertension and compared favourably with twice daily nifedipine.