Hypertension ‘storm surge’ in Asia Pacific
Today, Saturday, I’m delivering my valedictory address as outgoing president of the Asian Pacific Society of Hypertension. I titled my talk “Addressing the Hypertension ‘Storm Surge’ in the Asian Pacific Region.” I hope my call to action will be heeded seriously by the hypertension experts from 38 countries who attended the congress.
Hypertension and cardiovascular disease remain the top killer in most parts of the world, and in our country, they account for almost a third of all deaths. Hypertension causes heart attacks and strokes. It’s sad to note that despite all efforts, there is still an increase in the number of people dying from heart attacks and strokes in the last five years compared to 10 or 15 years ago.
Filipinos, similar to other Asians, are developing strokes and heart disease at a relatively younger age compared to the whites, despite having a leaner body frame. The most likely reason is that our blood pressure control is still dismally poor. Based on the survey conducted last year, only one out of five hypertensive patients has adequately controlled blood pressure. Some think they’re already protected if they take their medicines; but even if they do, it’s no guarantee of protection unless the blood pressure is optimally controlled.
It’s quite ironic that many claim they can’t sustain their intake of antihypertensive medicines because of the cost; and yet these same patients don’t seem to mind the increased cost of cigarettes and alcoholic drinks. Some of them also spend quite a good deal of money on some unproven herbal preparations just because they’re being endorsed by celebrities.
More intensive campaign
A more intensive public education campaign is still needed to drive home the message that it’s cheaper on the long run to take one’s medicines religiously for high blood pressure or heart disease. Fact is, not taking one’s medicines is a more expensive option because of increased risk of complications requiring expensive hospitalization and loss of productivity.
More than one-third of those who had strokes also become permanently disabled; many of these patients are usually at the peak of their lives. One can just imagine the severe socioeconomic burden hypertension and cardiovascular disease impose. The burden is not only on the patient and his/her family, but also on the government and entire society.
One of the barriers that has to be corrected for more optimal blood pressure control is the seeming lack of priority being given for hypertension and cardiovascular disease. Everyone knows they’re still the leading cause of death, killing around 120,000 Filipinos annually. That’s like having 12 Supertyphoon “Yolandas” yearly. Compared to HIV/AIDS or even pulmonary tuberculosis, the death rate from hypertension is much higher. But while we give free medicines for TB and HIV/AIDS, there’s hardly any available antihypertensive medicines being given for free to those who really can’t afford to buy them. I think some resetting of priorities is in order.
An increased salt intake is also a major culprit why our countrymen’s blood pressure is increasing. And it’s really not coming from the salt we’re using on the table, or whatever we add to cook our food. This is only around 20 percent of our daily salt intake. Around 80 percent of the food we take in is coming from processed food like canned goods and instant noodles. With these kinds of food, we can sometimes get instant hypertension, too. This is of course a joke, but it does not really exaggerate the impact of these salt-laden foods on the blood pressure on the long-term.
It’s really about time that food manufacturers be obliged to indicate prominently on their labels the amount of salt present in the food that’s being sold. Ideally, one should not take more than 1,500 mg of sodium daily. If you take even just two cups of a popular soup brand, you’ll be having more than 1,500 mg already. Some pizzas contain more than 1,000 mg per slice. If you eat two slices, you’ve already exceeded your salt quota for the day.
Salt, fat content
Not only should food manufacturers be required to indicate the salt (and fats too) on their label, they should be asked to gradually reduce the salt they use in their food products. This may make the food less palatable, but if done gradually, the consumer won’t notice, and if it’s properly explained to them with massive public education campaigns, I’m sure they won’t mind.
I know that the Philippine Food and Drug Administration headed by Dr. Kenneth Hartigan-Go has been working on this for quite some time already, but I guess it would take our food manufacturers more than gentle persuasion to reduce the salt content of their food products. I think it’s about time our legislators do their part and come up with laws to prevent the manufacture and sale of products that could be detrimental to public health.
The hypertension and cardiovascular disease “storm surge” is as real a problem as common colds or flu. Looking at the trajectory of the death rate caused by it, one dreads to imagine what will happen 10 to 15 years down the road if we don’t address the problem with a sense of urgency.
