Paris—Close to a hundred cardiologists from the Philippines joined more than 30,000 heart experts, scientists and researchers from all over the world in this beautiful city to learn new data and clinical insights on how to better understand, evaluate and treat cardiovascular disease (CVD), still the no. 1 killer worldwide.
It’s the annual congress of the European Society of Cardiology, one of the well-attended research olympics in cardiology.
In low- and middle-income countries like the Philippines, the prevalence of CVD continues to rise and is higher than cancer. But the incidence of heart disease in high-income countries appears to be on a decline, while the number of cancer cases increases.
Poverty and lesser education are now associated with poorer long-term outcomes, likely because of poorer access to adequate health care among the poorer segments of the population. Hopefully, the universal health law can address this and bridge the gap between the haves and have-nots when it comes to health care.
Of all the CVDs, high blood pressure (HBP) or hypertension remains the top killer, accounting for more than 10 million deaths globally each year. Awareness, treatment and control rates remain low.
In the Philippines, around 200,000 are dying yearly due to a heart attack, stroke, heart failure and other CVDs. It’s like having a fully loaded commercial plane crashing almost every day. Hypertension accounts for nearly half of CVD deaths.
Time and again, we’ve called for a more committed, purposeful, population-directed and risk-prioritized approach to control hypertension and CVD in our country. I’ve been advocating free low-dose diuretic-based antihypertensive regimen for those who can’t afford the more expensive antihypertensive medicines.
Low-dose diuretics
Low-dose diuretic is the cheapest (less than a third of the cost of other drugs), yet more effective for Asians, including Filipinos, because of our higher salt sensitivity.
The downside is that it has more side effects, but I’m sure many would prefer enduring these side effects in exchange for living longer, and not being disabled by a stroke or heart failure at one’s peak in life. This solution is quite simple, doable and affordable.
Another simple solution presented in the congress is that communities using nonsodium salt substitutes such as potassium chloride (KCl) instead of sodium chloride (NaCl) are able to achieve a modest but significant reduction in the population’s BP that can translate to less strokes, heart attacks and heart-related or cardiovascular deaths.
So, give your heart a break by using KCl more than real salt or NaCl. KCl may be considered as fake salt, but this is one instance when the fake item is better than the real thing.
A healthy lifestyle started early in life can pay off when one reaches his or her senior years. A paper presented here in Paris event involved a long-term study of around 1.7 million 18-year-old Swedish boys who were monitored till they were in their 60s. Those who were not too careful with their diets and were overweight in terms of higher body mass index (BMI) in their teenage years had a greater risk of a heart attack before age 65.
BMI during puberty
Dr. Maria Aberg of the University of Gothenburg, Sweden, explained: “We show that BMI in the young is a remarkably strong risk marker that persists during life. Our study supports close monitoring of BMI during puberty and preventing obesity with healthy eating and physical activity. Schools and parents can play their part by encouraging teenagers to spend less leisure time in front of a screen and providing healthy food.”
This finding is especially significant now because of modern-day gadgets and devices that lead to less physical activities, less sleeping hours and more intake of unhealthy or junk food.
The researchers observed the increase in risk starting with a BMI of 20 kg/m2, which is still considered normal, then increasing gradually, up to a 3.5-fold elevated risk of a heart attack in the severely obese— those with BMI of 35 or higher.
Compared to adolescents with BMI of 18.5 to 20 kg/m2, risk of heart attack were 2.64 and 3.05 times more for BMIs of 27.5 to 29.9 and 30 to 34.9, respectively.
This suggests that it’s best to be slightly less than one’s upper limit of BMI, which for Asians is 23. Being slim is in, and safer—preferably starting at a young age.