BAGUIO CITY – People experiencing shortness of breath should not take it for granted as it might cost one’s life if not given the needed medical attention from experts. It took his cousin to suffer a mild stroke before he realized the need for them to seek expert medical attention in Metro Manila.
In 2006, retired Police Director Eugene G. Martin and his cousin had been experiencing shortness of breath when doing various physical activities even within short period of time. The duo then sought medical advise from physicians in the city and they were advised that the primary cause of their shortness of breath is muscle problem.
“We were addicted to the usual traditional massage with the hope that our shortness of breath will be cured but our situation seems to worsen until such time that my cousin suffered from a mild stroke,” Martin explained.
The duo then decided to proceed to Metro Manila to seek a second opinion from other medical experts on their condition then. It was found out that some of the veins supply blood to their hearts has been blocked and there were two recommendations that were provided to them, one is to undergo open heart surgery or angioplasty stenting.
After learning the difference between the two medical procedures, they opted to undergo the angioplasty procedure with the condition that his cousin will be the first one so that he will be able to serve as his watcher. Unfortunately, his cousin did not survive the said procedure.
“I did not hesitate to undergo the procedure because I was assured that it was safe and will address my existing condition then. The untimely death of my cousin did not serve as a deterrent in my undergoing the said procedure because I relied on the assurance of the doctor that it will be safe and I want to live a longer life,” he added.
The 70-year old retired police official was supposed to have three stents but medical experts found out that that one of the defects to his veins was in born, thus, only two stents were placed through the said procedure. At that time, health facilities in the city did not have angioplasty procedures that is why they opted to go to Manila even if the same was quite expensive. In Martin’s case, he spent more than P1 million just to undergo the said procedure.
He was able to go back to work after one week and to date, there were no other major procedures that he underwent except taking in his prescribed maintenance medicines and that of the stents.
“People must take good care of their health by eating the right food, doing regular exercise and avoiding lavish lifestyle to live longer and enjoy life,” Martin said.
As a retired police official, he enjoys playing golf regularly that serves as his exercise and doing civic activities not only within Pugo, La Union but also in other parts of the Cordillera and Northern Luzon.
On the other hand, lawyer Brenda D. Poklay, whose husband died more than a year ago after a second heart attack, emphasized the importance of healthy living in the present times to avoid contracting life threatening illnesses that would lead to the untimely loss of love ones.
She narrated that her husband suffered a heart attack several years ago and was able to survive the same because he was able to feel the signs of severe headache, dizziness and difficulty of breathing while driving his vehicle. He reportedly parked his vehicle and flagged down a taxi that rushed him t6o the hospital where he was given immediate medication that paved the way for him to survive the said attack.
Since then, he religiously practiced healthy living but allegedly went back to his vices that caused him to gain weight.
Before his second attack, her husband attended a number of gatherings organized by their relatives where there were a lot of food coupled with heavy drinking and even less sleep because of the socialization that had been involved.
Unfortunately, he succumbed to his second heart attack at home and was only discovered by his relatives when they went home one evening in October 2023.
“Everyone must take care of their health because we do not want to lose our love ones early. We want to enjoy life with them because life is beautiful. My experience should serve as a wake-up call to the others to start making the necessary changes in their lifestyles to help them live longer and make the best of their lives with their love ones,” Atty. Poklay stressed.
She admitted that drinking alcohol, spending sleepless nights, smoking and eating too much meat are contributory in the deterioration of one’s health that is why as a piece of advise to the individuals who are into vices, they must already start moving away from the said vices and embrace healthy living for them to enjoy the fruits of life.
The wife of a 56-year old professional share her latest experience about the prevalence of cardiovascular diseases as her husband was among those who were immediately subjected to the angioplasty procedure after suffering from a near cardiac arrest just last week.
Her husband was about to drive her to their office when he suddenly backed off and asked his daughter to be the one to bring her mother to their office that day as he was not feeling well despite having prepared for it.
His family members, including his daughter, tried to inquire from him on what was wrong but he simply replied that he was not feeling well and went to lie down on the bed.
Her daughter decided to call her cousin who is a newly licensed physician to check on the condition of her father.
Upon taking his blood pressure, his nephew found out that it was too high and advised him to visit the emergency room of a nearby private hospital for him to be provided with further medical attention and to check on his condition. However, he initially refused but complained of a shooting pain inside his chest that prompted his nephew to insist that he be taken to the emergency room in the company of her daughter.
The wife added that after a few hours in office, she received a call from her daughter informing him that her husband had a mild heart attack and that it was found out in his angiogram that three of the main arteries leading to his heart were blocked, thus, the need for him to undergo the necessary angioplasty procedure that was readily available in the said hospital.
Luckily, he agreed to undergo the said procedure and that he was able to survive the same where three stents were inserted in the arteries to ensure the smooth flow of blood to his heart and the different parts of his body.
His wife claimed that he is doing good on his way to recovery and preparing for his regulated activities in time for the upcoming campaign period as he is an aspirant for an elected post in one of the provinces in the Cordillera.
The aforesaid stories are just a percentage of many more similar narrations of individuals and their relatives relative to their experiences on heart problems that boils down to the adherence of the people to healthy living to prevent them from contracting the life threatening illnesses that might compromise their productivity as one may either be totally or partially paralyzed, survive the attack or worst, end up lifeless.
Cardiovascular disease is top killer in Cordillera
Cordillerans are known to be carnivorous because meat is a major component of their food, especially during special occasions like weddings, birthdays, reunions, fiestas, baptisms, anniversaries, wakes among others. Aside from partaking of the food, attendees are always given the so-called ‘watwat,’ or a big slice of meat for their families that make them meat lovers.
Jocelyn Rillorta, head of the non-communicable cluster of the Cordillera office of the Department of Health (DOH-CAR), said that while the survival rate of those suffering from heart attacks is high at 90 percent if provided with immediate medical attention, the best way for people to avoid contracting cardiovascular illnesses is to take everything in moderation, have regular exercise and always be happy.
The most common type of cardiovascular diseases are coronary artery disease that occurs when arteries that supply blood become narrow due to the buildup of plaque which is known as atherosclerosis; high blood pressure or hypertension that is a condition in which the impact of the blood against the artery wall is too high; cardiac arrest that refers to the condition when the heat suddenly stops to function that causes the supply f oxygen and blood to stop resulting to unconsciousness and stroke which happens when the supply of the blood to the brain is interrupted that causes the cells in the brain to die immediately.
In the Philippines, non-communicable diseases, including cardiovascular diseases, account for 68 percent of all deaths, meaning one in every three Filipinos is likely to die by the age of 70 from one of the major non-communicable diseases. During the surge of the COVID-19 pandemic from 2020 to 2021, most of the deaths that were observed are those with co-morbidities, especially cardiovascular diseases.
In the Cordillera, 46 percent of COVID-19 related deaths had co-morbidities from the start of the pandemic to the year 2021 based on the data from the DOH-CAR. Most of them have hypertension, diabetes mellitus, heart disease, lung disease and cancer.
The DOH-CAR data showed that in 2023, majority or 90 percent of mortalities were non-communicable diseases such as cardiovascular disease, cancer, cerebrovascular disease, chronic kidney disease, hypertension, myocardial infraction, chronic obstructive pulmonary disease, diabetes mellitus and vascular disease.
Rillorta claimed that previously, those who have greater chances of contracting cardiovascular diseases are those aged 55 but in the present times, individuals aged as young as 20 can have said illnesses because of their sedentary lifestyle aggravated by the kind of food that are being served such as those having too much saturated and trans fats which are dangerous to the health of the young ones.
The DOH-CAR data showed that the lowest premature mortality rate of non-communicable disease was in 2019 with 32.06 percent and the highest was in 2021 with 76 percent of adults died from cardiovascular diseases.
The DOH-CAR NCD coordinator pointed out that hypertension is the leading risk factor for cardiovascular diseases where obesity resulting from insufficient physical activity and an unhealthy diet is a physiological risk factor leading to cardiovascular disease.
According to her, the common risk factors of cardiovascular diseases are tobacco use, alcohol use, dietary factors, including low fruit and vegetable intake, physical inactivity and overweight or obesity.
She underscored that healthy lifestyle approach should be practiced by people and that it should also be implemented in a variety of settings such as schools, work places, and health care settings that is one of the key message of the universal health care to have a healthy living, schooling and working environment.
She stipulated that evidence exists that school-based intervention to promote physical activity and improve diet are effective in controlling weight gain among schoolchildren.
The DOH-CAR noted that the prevalence of overweight among senior citizens was common in Benguet and Abra while in Mountain Province and Baguio City, it is nearly the same as the national estimate of overweight and obesity.
Rillorta emphasized the overweight and obesity leads to adverse metabolic effects on blood pressure, cholesterol and triglycerides and that physical inactivity is also a major contributor to the rise in the rate of overweight or obese not only in the Cordillera but worldwide and independently increases the risk of non-communicable diseases.
More importantly, she asserted that one must not forget that the promotion of healthy lifestyle starts for the womb which is the promotion of healthy pregnancy in the first 1,000 days, thus investing at an early stage of life in the prevention and promotion is a cost-effective strategy to control non-communicable diseases and live a healthy ageing in the future. Maternal pre-natal nutrition in the child’s nutrition in the first two years of life are crucial factors in a child’s neuro development and life-long mental health. Child and adult health risks, including obesity, hypertension and diabetes, may be programmed by nutritional status during the said period.
People must start taking the necessary action to prevent them from contracting the life-threatening illness;
A – ASCVD is a top killer in the Philippines
C – Cholesterol is a key risk but can be managed
T – Take action to lower it fast
NOW – The next heart attack or stroke could be worse — act now to stay protected.
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Rediscovering indigenous lifestyle
Retired Mountain Province Assistant Provincial Health Officer Dr. Penelope A. Domogo, who was a strong advocate for healthy lifestyle having been a strict vegetarian for more than seven years, said that indigenous peoples are actually blessed because of the gift of nature and food that when actually explored and taken advantage of will allow them to save a significant portion of their income being spent for food because of the abundance of the healthy food within their surroundings.
“We had to start our advocacy by setting the example to show the people that we are practicing what we preach. We want also to show that health workers advocating for healthy lifestyle are healthy for them to be convinced to embrace the practice of healthy living,” Domogo stressed.
In 1988, she started experiencing irregular heart beat that promoted her to seek advise from Baguio-based cardiologists. She was prescribed maintenance medicines but she continued to suffer from such heart problems for several years under she was diagnosed to have myoma and heart problems that caused a sudden turnaround in her lifestyle.
In 2000, the former rural health doctor chanced upon an article on ecological living written by Dr. Susan Balingit that caught her attention on the importance of living in harmony with nature and maximizing the potentials of available healthy foods in the environment.
In what she described as ‘a universal coincidence, Balingit was hired by the health department as a consultant on women’s health and development and Mountain Province where Dr. Domogo was assigned was chosen a pilot area of the project, thus, she had a chance to engage with the former and learned from her the importance of healthy living and being able to live peacefully and in harmony with nature without spending much for food as they are readily available in the environment where people live.
Domogo disclosed that it was in Mountain Province where the project entitled ‘rediscovering indigenous lifestyle to care for our health’ was conceptualized pursuant to the initiative of the health department that led to the organization of community health teams in the grassroots level to help in the implementation of the advocacy. It was also tat that time where the provincial government established the collation for healthy lifestyle that started the enforcement of the ban on soft drinks being served in gatherings and the search for healthy places which had been carried on from the time of the late Gov. Leonard G. Mayaen up to the current administration of Gov. Bonifacio C. Lacwasan, Jr.,
“It is really difficult to impart change but what is enriching about our experience is that people realize the benefits of the food that is readily available right in their surroundings. We had to really practice what we preach that allowed many of our beneficiaries to also emulate although there were others who tried to discredit our efforts but in the end saw the light at the end of the tunnel,” Domogo added.
She claimed that there was a time where even gatherings in the barangays that they visited served camote and other healthy foods for snacks and meals that made people realize that they can actually save money from doing so because they no longer need to buy expensive snacks from stores or other establishments in their communities.
By practicing being a strict vegetarian, her illnesses were actually cured that set an example to the people that when there is the will to practice healthy lifestyle, t6heir health will significantly improve for the better and have the chance of prolonging their life in this world.
Domogo became popular not only in the province but also in the Cordillera as an advocate for healthy lifestyle because he practice what she had been teaching and that positive testimonies by the people whom they have informed and educated served as her inspiration and motivation to sustain the said advocacy that even her children who are all professionals [practiced being strict vegetarians.
“We cannot avoid negative criticism about our advocacy but in the end, those who had been issuing negative comments approached me and informed me abut the benefits that they were able to experience from observing healthy lifestyle after suffering from certain illnesses,” she said.
Now, she enjoys taking care of her grandchildren and teaching them to embrace healthy living while they are young so that they will learn to value the importance of being healthy to be able to be productive in their respective endeavors in the future.
Bad cholesterol is a ‘silent killer’
Health experts underscored that low density lipoprotein cholesterol (LDL-C) or the so-called ‘bad cholesterol’ is a ‘silent killer’ that continues to pose a serious threat to the lives of Filipinos who continue to practice unhealthy lifestyle. Baguio food tours
Dr. Lourdes Ela Santos, Head of the Preventive Cardiology of the Cardinal Santos medical Center, pointed out that unlike high blood pressure or blood sugar, high bad cholesterol levels are asymptomatic and can give a false sense of security as high LDL-C often causes heart attacks or strokes, thus, it is essential to monitor cholesterol levels along with blood pressure and blood sugar.
However, she claimed that not all cholesterols are bad as the high-density lipoprotein (HDL) is considered as the good cholesterol, thus, if the number is high, it means that a person has good cholesterol in his or her body.
Experts define cholesterol as a waxy, fat-like substance which is also considered a type of lipid and plays an important role in making hormones and digesting fatty foods.
She advised that bad cholesterol could lead to heart attacks or strokes, thus, people should keep it low.
Santos explained that the three types of cholesterol that exists in a person’s body are the triglycerides which are the most common type of fat that store excess fat from the diet and is considered to be harmful to one’s body; the HDL-C or good cholesterol which destroys the LDL and protects one’s heart, thus, it should be high and LDL-C which is the bad cholesterol and poses a serious threat to the heart of individuals.
According to her, cardiovascular disease is the leading cause of death worldwide, taking more lives each year than cancer, respiratory disease and diabetes combined, and contributes to one in every three deaths globally.
In the Philippines, Santos claimed that cardiovascular disease is the leading non-communicable disease with atherosclerotic cardiovascular disease as the top contributor.
Further, nearly two out of ten deaths among Filipinos are due to ischemic heart disease, a type of cardiovascular disease caused by narrowed arteries that supply blood to the heart muscles. Atherosclerotic cardiovascular disease includes ischemic heart disease and cerebrovascular disease which are the top causes of deaths in the country in 2020.
Santos disclosed that the top three causes of atherosclerotic cardiovascular disease are high systolic pressure, high fat diet, and elevated LDL-C.
The health expert revealed that those who have had a heart attack are six times more likely to have another attack and stroke survivors are nine times more likely to have another stroke. The risk of a recurrent heart attack is the highest within the first year of having a heart attack.
She emphasized that the Philippine Lipid and Atherosclerosis Society and other medical organizations have recommended stricter LDL-C targets for those with a history of heart attacks, strokes, or cardiovascular procedures. The goal is 70 mg/dl for diabetics with additional risk factors and 55 mg/dl for heart attack or stroke victims.
More importantly, Santos said that lower LDL-C levels can help prevent serious events like strokes and heart attacks, so knowing one’s risk and cholesterol goals is crucial.
She reiterated that people of all body types can have high LDL-C, and often feel fine despite such high bad cholesterol. LDL-C or bad cholesterol moves from the liver throughout the body. High LDL-C levels cause fat deposits or plaques on blood vessel walls, narrowing them and reducing blood flow, which can lead to heart attacks. The main cause of high bad cholesterol is an unhealthy lifestyle such as eating lots of unhealthy fats found in some meats, dairy products, chocolates, baked goods, and fried or processed foods.
Santos stipulated that long-term exposure to high cholesterol levels can have severe effects on one’s health, primarily due to the build up of fatty deposits in the blood vessels. The said buildup known as plaque can narrow the vessels and restrict blood flow, leading to a range of cardiovascular conditions
Moreover, LDL-C gets deposited on the walls of blood vessels and as the fat deposits, plaques become larger, the blood vessels become narrower and blood flow is impaired. The plaque can sometimes burst leading to blood clot. The affected body tissue may no longer receive adequate oxygen. Narrowing of blood vessels in the heart can cause chest pains or a heart attack. Narrowing of the arteries in the brain may cause a stroke. Constriction of blood vessels in the legs or pelvis leads to peripheral arterial occlusive disease.
Santos admitted that lifestyle changes and medication are crucial, especially for those who have had a heart attack or stroke, to meet the recommended bad cholesterol levels. After such evens, additional support is needed to prevent recurrence. Cholesterol lowering medications generally offer more benefits than risks and newer options can significantly reduce LDL-C with fewer side effects.
She suggested that consulting a physician is essential to assess risks and find the right treatment.
However, patients often find it challenging to stick with cholesterol lowering treatments as half of patients stop taking statins within a year and 80 percent of those in statins do not achieve their recommended targets.
Even though patients cannot feel changes and proper medication can effectively lower LDL-C, she reminded people that reducing the risk of heart events and mortality remains evident
With new medications, more patients are now reaching target levels, altering outcomes for those at high risk of a second heart attack or stroke.
Heart health diet
A Baguio-based cardiologist underscored the importance of strictly adhering to the seven steps for a heart healthy die and avoid their current unhealthy eating habits to avoid contracting life-threatening heart ailments.
Dr. Carla Rhea G. Rillera-Posada, a cardiologist of the Baguio General Hospital and Medical Center (BGHMC) said that there has been a significant increase in people contracting life-threatening heart ailments primarily because of their unhealthy eating habits, thus, the need for them to start refocusing their attention to the seven steps towards a heart healthy diet to reduce their risks in contracting the said illnesses and for them to remain healthy.
She reminded people to use a small plate or bowl to help control their portions aside from eating lower calorie, nutrition-rich foods, such as fruits and vegetables and eat more smaller amounts of high calorie, high sodium foods such as refined, processed or fast foods.
The medical doctor advised people to eat more vegetables and fruits as vegetables are rich in vitamins and minerals, low in calories and rich dietary fibers for weight loss.
Among the fruits and vegetables that should be eaten are those fresh or frozen, low sodium canned vegetables and canned fruit packed in juice or water while the fruits and vegetables to limit are coconut, vegetables with creamy sauces, fried or breaded vegetables and canned fruit packed in heavy syrup.
Posadas claimed that people must learn to select whole grains and that the grain products to choose are whole-wheat flour, whole-grain bread, preferably 100 percent whole-what or whole-grain bread, high fiber cereal with 5 grams or more fiber in a serving, whole grains such as brown rice, barley and buckwheat or kasha and whole grain pasta. The grain products to limit and avoid are white refined flour, white bread, muffins, frozen waffles, corn bread, donuts, biscuits, quick breads, cakes, pies, and egg noodles.
More importantly, she said that people must limit unhealthy fats and that the fats to choose are olive oil, canola oil, vegetable and nut oils, margarine, trans fat free cholesterol lowering margarine such as Benecol, Promise Activ or Smart Balance, nuts, seeds and avocados while the fats to limit are butter, lard, bacon fat, gravy, cream sauce, non-dairy creamers, hydrogenated margarine and shortening and cocoa butter.
According to her, people must also choose low fat protein to be able to achieve the purpose of having a healthy heart and avoiding heart-related and life-threating heart illnesses.
Posadas pointed out that people must also reduce their sodium intake by avoiding food that are filled with sodium such as tocino, longganisa, hot dog, red egg among others. Canned foods must be rinsed to reduce sodium content. When eating outside residences, people must learn to request that salt must not be added and ask for sauces and salad dressings on the side so that they can control the amount to be used.
On the lighter side, she asserted that people must allow themselves for an occasional treat where they must allow themselves an indulgence every now and then since what’s important is that they eat healthy foods most of the time.
One of the recommended diets for a heart healthy diet, according to Posadas, is the Mediterranean diet because it has lots of vegetables and fruits, lots of whole grains lie whole wheat bread and brown rice, extra virgin oil as a source of fat, moderate amount of fishes rich in Omega 3 fatty acids, moderate amount for cheese and yogurt, more in poultry, little or no red meat, little or no sweets, sugary beverages and butter and moderate amount of wine.
She explained that some of the advantages of the Mediterranean diet are lower risk of cardiovascular disease supporting healthy blood sugar, blood pressure and cholesterol, supports healthy weight, support a good digestive system, slows down decline of brain function as one ages and helps fight certain types of cancer.
The health expert disclosed that wine is often associated with Mediterranean diet as it can be included but only in moderat5ion, particularly one half glass every after dinner, no more, no less.
Another recommended diet for a heart healthy diet is the so-called Dietary Approach to Stop Hypertension (DASH) diet which is a healthy eating plan designed to help treat or prevent high blood pressure or hypertension.
The foods to take are vegetables, fruits, whole grains, fat-free or low fat dairy, fish, poultry, beans, nuts and seeds and vegetable oils while foods to limit are fatty meats, whole-fat dairy, sugar sweetened beverages, sweets such as ice cream and sodium intake.
She clarified that the Mediterranean diet focuses on promoting general cardiovascular health while the DASH diet is an eating plan that aims to lower blood pressure.
She disclosed that saturated fats found in red and processed dairy products, coconut milk and palm oil as well as foods made from the same such as cakes, biscuits and pastries increase the amount of bold cholesterol in the blood. It in turn increases the risk of cardiovascular diseases including chronic heart disease.
On the other hand, unsaturated fats found in nuts, seeds, avocado, oily fish and cooking oils made from plants such as olive oil and rapeseed oil, have been found to decrease the blood levels of LDL and decrease the risk of cardiovascular disease.
“It is true that nuts have a high fat content, however, most of these is the heart healthy unsaturated fat. Nuts are also a good source of micronutrients such as manganese, potassium, iron, zinc, selenium, vitamin E and B and are high in both protein and fiber, so, overall, a very healthy option,” she noted.
She agreed that chocolates are high in anti-oxidants and there is some evidence that consuming high levels of these anti-oxidants are linked to heart health. But most of the anti-oxidants content is removed during processing and very little remains in the chocolate that people eat.
Posadas admitted that eggs are low in saturated fat and have many other nutritional benefits, thus, for the general healthy population, they can be included as part of a heart healthy diet. For those with familial hypercholesterolemia (FH), high blood cholesterol levels and those who are at high risk or have cardiovascular disease, it is recommended that they limit their intake to three to four eggs a week.
Earlier, studies have shown that fats made up entirely of MCT increase good cholesterol and that coconut oil contains just 15 percent MCT. It is important to note that coconut oil is made up almost entirely of the unhealthy saturated fat.
This article is part of the Unblock Your Heart Health Reporting initiative, supported by the Philippine Press Institute and Novartis, to improve health literacy on cardiovascular diseases. Know your numbers, understand your risks, and consult your doctor—so no Filipino heart is lost too soon. Take control of your heart health today. Visit unblockedmovement.ph for more information. By Dexter A. See
