Do you know your basic CV numbers?By Rafael Castillo
Philippine Daily Inquirer
Earlier this week, more than a thousand heart specialists and physicians treating adult patients with cardiovascular problems attended the three-day annual convention of the Philippine Heart Association (PHA).
Many of the topics tackled prevention, and emphasized that it’s a lot more complicated and usually exasperating for the physician when the patient comes with all sorts of complications already in the vital organs like the heart, kidney and brain. Eventually the patient dies because of multi-organ failure already, which could have been prevented had the cardiovascular risk factor been treated much earlier on.
No wonder, cardiovascular disease, or CVD, is still the No. 1 cause of deaths in our country and all over the world. It has been so for the last 15 years or so, and it doesn’t look like the statistics is going to change anytime in the foreseeable future.
This is one big challenge that cardiovascular specialists have to address. Despite all efforts by medical organizations like the PHA at public health education, it doesn’t seem to be creating any significant impact on the prevalence of CVD. The mind-set of the public needs a big deal of reorientation—from disease treatment to disease prevention or health promotion.
Compliance or adherence to a physician’s recommendations remains a major challenge. Lifestyle intervention measures have been proven time and again to have significant impact in preventing CVD; yet, many find it difficult to adhere to the prescribed healthy diet consisting of low-fat, high-fiber; ample fruits, vegetables and nuts; and sweets in moderation.
Many can spend hours on end on the computer, yet would find all the excuses not to exercise even just for 30 minutes most days of the week. Modern-day conveniences such as the use of remote controls to operate appliances like TV sets or air conditioners only aggravate the lack of physical activity of most adults.
At least before, one had to walk a few paces every now and then to change channels, adjust the volume or fine-tune the picture; and somehow, these made for a surrogate form of physical activity burning up some excess calories. Now, the doting and handy remote control has taken that away.
Efforts at curbing smoking
That some people still consider the cigarette stick as their soothing companion when they’re stressed or engrossed at work, despite all the scientific data showing that it kills more people than natural calamities, vehicular accidents and common diseases combined, is one big puzzle I haven’t solved myself. It is our fervent hope that the “sin tax” bill being finally enacted into a law is just the start of the government’s continuing efforts at curbing smoking, especially among the youth.
Just as compliance to health-promoting activities is a big problem in countries like ours, making patients adhere to early treatment when risk factors to the disease are detected is equally a big problem. In general, patients comply with treatment only when intolerable symptoms or life-threatening complications are present already; not during the early stages of CVD or even earlier on to prevent the risk factors that cause CVD.
Initial presentation of CVD
Here lies the problem. Risk factors like high blood pressure, diabetes and cholesterol problems are present for quite a long period of time—generally for more than 10 years—without causing any symptom. When one starts to develop bothersome symptoms, serious damage on the vital organs may be present already. In fact for some unfortunate ones, a massive heart attack or stroke, or even sudden death is the initial presentation of CVD in the unsuspecting victim.
“But how would we know we have the risk factor if we don’t have any symptom?” This is probably the most frequent question I hear from patients who get a piece of the doctor’s mind whenever they come in a complicated stage already. It only takes five minutes max to check one’s blood pressure. It only takes a single blood exam to check if one has diabetes or cholesterol problems. If one can’t even find time for these tests once a year, then such indifference to one’s health is inexcusable.
Sometimes, we hear also patients thinking that they’re still on the safe zone when they have borderline blood pressure or pre-hypertension, or borderline diabetes. Doctors are trying to avoid these “borderline” terminologies because they imply that the values or numbers are still in the high-normal range and should not put the patient in any degree of risk.
Researches in the last 10 years have shown that these patients with so-called “borderline” cardiovascular risk factors are already at increased risk compared with those with completely normal or optimal numbers. These patients have to be monitored and starting them on treatment may help prevent serious complications in the future.
So if you still don’t know your basic numbers—blood pressure, blood sugar, cholesterol and basic blood chemistries—it’s about time you did and you’ll be doing yourself a great favor for doing that.
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