I first saw patient Ricardo A. around 25 years ago, when he first discovered he had high blood pressure (BP). He was in his mid-30s then. He did not feel any symptoms, though his BP would reach alarming levels of more than 180/100 mm Hg. And because he had no symptoms, he felt it was not necessary to take the medicines we prescribed. “The medicines made me feel sicker because of the side effects,” he once told me.
Ricardo rarely reported for follow -up, and only did so when he needed clearance for employment or consulted for some other complaints not related to his hypertension. But some time last year, he knew something was terribly wrong.
He had progressive difficulty breathing, initially with moderate physical activities like washing his car or going up the stairs, but later, even with minor exertions like walking a block or taking a bath.
With his medical history of erratically treated high BP and physical exam findings of enlarged heart, edema of the legs and neck vein engorgement due to fluid retention, Ricardo realized that what we had been warning him about had happened.
Severe heart failure
The lab results confirmed that he was having severe heart failure, with the heart’s ejection fraction (an indicator of heart function) barely a third of what it should be. His kidneys were also failing, as shown by high levels of waste in the blood because his failing kidneys could no longer excrete them adequately.
All options to salvage his failing heart and kidneys were explained to him, but he refused all aggressive treatments, and opted for conservative medical management.
He apparently improved for a while, and with the temporary relief from his symptoms, he backslid once again in his compliance to treatment. Last week, his wife informed us that he had died suddenly, apparently with no warning.
There are thousands of cases like Ricardo in our country, and yearly nearly 200,000 Filipinos are dying directly or indirectly from high BP.
This week, experts, practicing physicians, and health officials involved in the treatment and prevention of high BP all over the Philippines will gather during the joint annual convention of the Philippine Society of Hypertension (PSH) and Philippine Lipid Society. It looks like we really need more innovative strategies to stem the tide of hypertension in our country.
Professor Neil Poulter, president of the International Society of Hypertension (ISH) based in the United Kingdom, will deliver one of four plenary lectures on various aspects of hypertension and heart diseases. Doctors Romeo Divinagracia, Eugene Ramos and myself will deliver the three other plenary lectures.
The three-day confab also has more than 20 symposium lectures, panel discussions and debates. I wish to commend the organizers, headed by Dr. Lynn Gomez and Dr. Ramos, for an excellent scientific program, and I encourage physicians and healthcare professionals involved in hypertension prevention and control to attend this convention. (You may register onsite on Feb. 23, at the Crowne Plaza Hotel in Pasig City.)
Dismally inadequate
Our highly respected Ombudsman, Conchita Carpio Morales, will deliver the keynote address during the opening ceremonies. We have no idea what she’s going to say, but it would be interesting if she would relate the political situation with hypertension and heart diseases.
Going back to the problem of hypertension, it is quite disheartening that despite all efforts by the government and various medical organizations involved with hypertension control, the awareness, treatment and control of hypertension remain dismally inadequate in our country and worldwide.
One out of three Filipino adults have high BP but half of them are not aware they are hypertensive. It calls for doubling, and more importantly, sustaining our collective efforts to diagnose those with high BP and start them on treatment to prevent disabling and potentially fatal complications.
In this regard, the ISH and the World Hypertension League (WHL), in collaboration with the PSH, is embarking on a whole-month awareness campaign this coming May. Dubbed the May
Measurement Month 2017 (MMM17), it is a massive global campaign of increasing awareness, and measuring the BP of those who have not done so in the preceding year.
The goal is to screen at least half a million adult Filipinos, aged 18 years and older, in any of at least 500 sites we hope to organize throughout the country. We need volunteers—doctors, nurses and anyone who is willing to be trained to take the BP using automated digital devices. (Interested parties may e-mail MMM17@ish-world. com or phihpn@yahoo.com, or call 0917-6255810).
With a sustained BP awareness program, we can hopefully increase treatment and control rates in our country. Some counties like Japan, United Kingdom, Canada and Finland have done it, reducing strokes by as much as 75 percent, cutting heart attacks by a third and heart failure in half. This can translate to tens of thousands of lives saved from the fatal clutches of high BP.
As professor Poulter enjoins everyone, “Let’s help make a difference; let’s all help in saving lives.”