Growing number of young patients alarms heart docs

No one wants to have an angioplasty or a bypass surgery performed on him or her at the prime of life. But in the Philippines, like in many countries, this has become a disheartening reality.

As early as 2001, the Philippine Heart Association’s Philippine Health Situationer of the Community Health Development revealed that every nine minutes, a youngster below 15  dies of heart disease, and across all ages, diseases of the heart and the vascular system remain as the top two most common causes of death in the country.

Twelve years later, the same killers prey upon the most number of Filipinos. Heart disease accounts for approximately half of all deaths in the country. The National Statistics Office in 2009 revealed that on average, nearly 300 individuals die from heart disease everyday, the equivalent of one jumbo jet filled with passengers crashing every day.

Coronary artery disease (CAD) is the most common form of heart disease, and the World Health Organization estimates that 17 million people worldwide die of cardiovascular disease every year.

Two cardiovascular experts during the Philippine launch of Abbott’s Absorb—the world’s first drug eluting fully bioresorbable vascular scaffold, a device for treatments of patients with CAD—lamented how young some of their patients were.

“The youngest patient that we did angioplasty on was 28. If you look at medical literature, there are people who have an angioplasty in their early 20s. The youngest patient that I had to send to bypass surgery was 29,” reveals Dr. Timothy Dy, head of Aortic Endovascular Unit, Heart Institute, Chinese General Hospital and Medical Center.

Not immune

Dy adds: “Being 40 certainly doesn’t mean you’re immune to heart disease. About a third of the people who have significant heart disease and who are about to have a heart attack don’t have any symptoms. Absence of symptoms doesn’t mean absence of the disease.”

Dy says that the early onset of CVD is detectable, but that “they have to get themselves tested.”

The usual test would include a stress, or treadmill, test, especially for those who have a family history of stroke, or heart attack. “They need to be tested and they need to be screened for possible disease that up to now would not have exhibited any symptoms,” Dy stressed.

Dr. Erwin Dizon, chair and executive director of the Cardiovascular Institute of the Cardinal Santos Medical Center says that the cause of CAD is “multifactorial”—it cannot be attributed to just one cause. The major risk factors include smoking, high blood pressure, diabetes, cholesterol and family history.

Dizon urges people who have hypertension, high cholesterol and diabetes to be tested, as oftentimes this would be the only way these diseases could be detected.

Diet a major factor

In another data, the National Nutrition and Health Survey, an interagency study participated in by the Food and Nutrition Research Institute, shows that 90 percent of Filipino adults have at least one risk factor for atherosclerosis (the thickening of the walls of the artery as a result of the accumulation of fatty materials), which can lead to heart disease, organ failure, stroke and a host of other so-called lifestyle diseases.

The study identified the risk factors as dyslipidemia (high cholesterol level), diabetes, hypertension, smoking and obesity.

A new study published in the New England Journal of Medicine showed that a byproduct of dietary choline, a component abundantly present in animal products, can lead to greater risk of heart attack, stroke, and death in humans.

The study, conducted this year and titled “Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk (Tang WHW, Wang Z, Levison BS),” was also the basis for the Physicians Committee for Responsible Medicine (PCRM)’s printed article titled “Component of Animal Products Increases Risk of Heart Disease,” issued April 26.

Beef, pork, poultry

The Washington-based PCRM pointed out that the human body produces cholesterol for its own need, thus there would be no need for external sources. It revealed that cholesterol is found in all foods that come from animals: Red meat, poultry, fish, eggs, milk, cheese, yogurt, and every other meat and dairy product.

“Choosing lean cuts of meat does not spare anyone from cholesterol. In fact, cholesterol is found mainly in the lean portions. Chicken contains as much cholesterol as beef, as every four ounce serving of beef or chicken contains 200 milligrams of cholesterol,” said a PCRM statement.

The PCRM cited that when battlefield casualties were examined during the Korean and Vietnam wars, American soldiers as young as 18 had significant atherosclerosis. Their Asian counterparts, raised on a diet consisting mainly of rice and vegetables, had much healthier arteries.