MANILA, Philippines—My mother is one of the over 10 million Filipinos with high blood pressure or hypertension. She also belongs to the 80 percent of hypertensive Filipinos who are unable to control their blood pressure. In 1992 and again in 2005, she suffered a stroke that left her nearly half-paralyzed.

Over a billion people in the world suffer from hypertension, a figure expected to rise to 1.5 billion by 2025. Each year, about 1 in 8 deaths globally (7 million deaths per year) can be attributed to hypertension. As we celebrate World Hypertension Day today, it is vital that we prioritize the prevention and control of this silent killer.

“The higher a person’s blood pressure, the greater is his or her risk of suffering a heart attack, heart failure, stroke, and kidney disease,” warns Dr. Antonio Sibulo Jr., director of the St. Luke’s Medical Center Heart Institute.

Trusted by Filipino patients for over 20 years now, St. Luke’s Heart Institute is equipped with state-of-the-art technology and staffed by topnotch specialists trained to diagnose and treat patients with hypertension and cardiovascular diseases. It offers a broad range of comprehensive cardiac executive checkup packages designed to provide maximum patient convenience and meet unique personal requirements. Patients may choose an outpatient cardiac executive checkup package or one that lets them enjoy a comfortable one- or two-night stay at St. Luke’s.

Recommendations

Experts recommend maintaining a blood pressure of less than 120/80 mmHg. The top number is called systolic blood pressure (SBP) while the bottom number is called diastolic blood pressure (DBP). Citing the latest expert recommendations, Dr. Sibulo says that individuals with a SBP of 120-139 mmHg or a DBP of 80-89 mmHg are considered prehypertensive and require health-promoting lifestyle modifications to prevent cardiovascular disease (CVD). Those with blood pressure of 140/90 and above mmHg are considered hypertensive and may require medications on top of lifestyle modifications.

For hypertensive patients with good blood pressure control, Dr. Sibulo recommends weekly BP check preferably in the morning on waking up since blood pressure may be highest at that time. For those with difficult-to-control hypertension, he recommends at least a thrice-weekly BP check.

Lifestyle modifications

Adopting a healthy lifestyle is critical for the prevention of hypertension and an indispensable part of hypertension management, Dr. Sibulo stresses. Major lifestyle modifications proven to lower blood pressure include:

• Losing weight for overweight or obese individuals

• Eating a diet that is low in salt and high in potassium and calcium

• Engaging in regular physical activity

• Moderating alcohol consumption

“Lifestyle modifications lower blood pressure, enhance the efficacy of antihypertensive medications, and decrease cardiovascular risk,” Dr. Sibulo explains.

Antihypertensive drugs

There are several classes of antihypertensive drugs proven to lower blood pressure and reduce the complications of hypertension. These include angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs), thiazide-type diuretics and very recently, direct renin inhibitors (DRIs).

“More than 60 percent of patients with hypertension will require two or more antihypertensive medications to achieve the recommended blood pressure target of less than 140/90 mmHg, or less than 130/80 mmHg for patients with diabetes or chronic kidney disease,” Dr. Sibulo stresses.

He underscores the importance of a single, once-daily pill in simplifying hypertension treatment regimen. “A fixed-dose combination of two blood pressure-lowering drugs in one pill is more convenient and less expensive than taking several antihypertensive drugs, thereby helping improve patient compliance.”

He cites a new once-daily pill that contains the CCB amlodipine and the ARB valsartan, which work together in two different complementary ways to lower blood pressure. “If high blood pressure is properly controlled through lifestyle modification and medications, the incidence of stroke can be reduced by almost half, heart attacks by 25 percent and heart failure by half.”

Caused by organ disease

Dr. Sibulo notes that hypertension is not a disease but rather a condition caused by an organ disease. Because hypertension involves the entire vascular, its effects are systemic. Moreover, patients with hypertension often suffer other diseases and conditions, such as diabetes and high cholesterol; stroke, kidney disease and heart failure are common among hypertensive patients. As such, diagnostic tests to confirm or rule out these complications are paramount, he adds.

“Hypertension can damage the heart, brain, eyes and kidneys,” Dr. Sibulo stresses. “St. Luke’s Heart Institute offers a comprehensive range of diagnostic tests to determine the presence of target organ damage, which can help doctors to prescribe the appropriate therapy.”

For feedback, please e-mail the Healthcare Technology and Outcomes Information Bureau at inquire@htoib.com. For more information about St. Luke’s Heart Institute cardiac executive check-up packages, please call 723-1206.