OBJECTIVE: The prevalence of hypertension is 20% in the Philippines, and it increases year after year. It remains a risk factor for coronary heart disease, stroke, and heart and renal failure. The gravity of complications from hypertension also reflects the effectiveness of the awareness programs in the Philippines. The patient population of the Philippine General Hospital (PGH), being a tertiary referral center in the Philippines, has been represented by indigenous groups of Filipino people from the different provinces in the Philippines. In 1966, Dr. Baltazar conducted a study on the pattern of distribution of hypertension in PGH. It showed that essential hypertension was the leading cause of admission in PGH. This study aims to determine the prevalence and distribution of hypertensives admitted to PGH after for decades of improvement in the diagnosis and treatment of hypertension in the Philippines.

METHODS: Chart review of all hypertensive patients admitted at the charity wards or intensive care units in PGH in 2005 was performed. The year 2005 was selected due to the limitation of the Medical Records Section in retrieving charts before that year. Data from the Department of Pediatrics was excluded due to the insignificant number of hypertensives seen by the Department.

RESULTS: The information obtained from this study showed a decline in prevalence from 8.4% in 1966 to 4.1% in 2005 with a predominance of pregnancy-related hypertension in 1966 compared with primary hypertension in 2005.

CONCLUSION: This comparative study shows an expected decline in the prevalence of hypertension among admitted patients which can be attributed to heightened hypertension awareness, screening programs, and good quality of care.

Human ; Risk Factors ; Prevalence ; Hospitals, General ; Tertiary Care Centers ; Hypertension, Essential ; Hypertension ; Stroke ; Coronary Disease ; Renal Insufficiency

OBJECTIVE: To validate the Filipino version of the Berlin questionnaire (BQ) as a tool to screen for the risk of obstructive sleep apnea (OSA) in a primary care patients.

BACKGROUND: Most patients with OSA are unrecognized and untreated. The BQ is a tool that has been validated to screen for patients at risk for OSA and has been translated into and used in different languages.

METHOD: The forward and backward translation method was applied. The Filipino version was administered to 40 individuals able to read and understand both English and Filipino in different communities within the Metro Manila area followed 24 hours later with the English version. A focused group discussion and feedback were done after.

RESULTS: The BQ in Filipino showed good construct validity supported by the Cramer's coefficient ranging from 0.802 to 1 (p

CONCLUSIONS: The BQ in Filipino showed high construct validity. It can now be used as a research tool to conduct studies on risk assessment and disease correlation with OSA in the local community. It may likewise be used as a screening tool especially in areas with limited resources in order to identify patients who may need further workup for OSA.

Human ; Male ; Female ; Adult ; Young Adult ; Berlin ; Translating ; Translations ; Sleep Apnea, Obstructive ; Risk Assessment ; Primary Health Care

Cardiovascular disease is a leading cause of mortality in the Philippines with an upward trend in the prevalence of atherosclerosis-related risk factors. In the national survey done in 2008, the prevalence of dyslipidemia is also increasing. As such, there is a need to increase awareness of the risk factors for cardiovascular disease among health care professionals. The development of Philippine guidelines were part of the strategy to improve overall cardiovascular risk and dyslipidemia management that is relevant to the Philippine setting. This article summarizes the 2005 Dyslipidemia guidelines, discusses some updates since its release and emphasizes equity issues when considering management of dyslipidemia in a Filipino patient.
Dyslipidemias ; Practice Guideline ; Philippines ; Cardiovascular Diseases ; Asia

Dyslipidemia is a cardiovascular risk factor that is increasing in prevalence in the country. The need to treat and manage elevated cholesterol levels, both pharmacologic and non-pharmacologic, is of utmost importance. Different medical societies and groups bonded together to formulate the 2020 Philippine Clinical Practice Guidelines for dyslipidemia. The group raised nine clinical questions that are important in dyslipidemia management. A technical working group analyzed the clinical questions dealing with non-pharmacologic management, primary prevention for both non-diabetic and individuals with diabetes, familial hypercholesterolemia, secondary prevention, adverse events of statins and the use of other lipid parameters as measurement of risk for cardiovascular disease. Randomized controlled trials and meta-analyses were included in the GRADE-PRO analysis to come up with the statements answering the clinical questions. The statements were presented to a panel consisting of government agencies, members of the different medical societies, and private institutions, and the statements were voted upon to come up with the final statements of the 2020 practice guidelines. The 2020 CPG is aimed for the Filipino physician to confidently care for the individual with dyslipidemia and eventually lower his risk for cardiovascular disease.
Dyslipidemias ; Hyperlipoproteinemia Type II ; Diabetes Mellitus

Objective. Several studies showed that genetic factors affect responsiveness to statins among different populations. This study investigated the associations of candidate genetic variants with poor response to statins among Filipinos.

Methods. In this unmatched case-control study, dyslipidemic participants were grouped into statin responders and poor responders based on the degree of reduction in LDL-c from baseline. DNA from blood samples were genotyped and analyzed. The association of candidate variants with statin response was determined using chi-square and logistic regression analysis.

Results. We included 162 adults on statins (30 poor responders as cases, 132 good responders as controls). The following variants are nominally associated with poor response to statin among Filipinos at a per-comparison error rate of 0.05: rs173539 near CETP (OR=3.05, p=0.015), rs1800591 in MTTP (OR=3.07, p=0.021), and rs1558861 near the BUD13-ZPR1-APOA5 region (OR=5.08, p=0.004).

Conclusion. Genetic variants near CETP, MTTP and the BUD13-ZPR1-APOA5 region are associated with poor response to statins among Filipinos. Further study is recommended to test the external validity of the study in the general Filipino population.

Lipids ; Hydroxymethylglutaryl-CoA Reductase Inhibitors

Background. Low levels of high-density lipoprotein cholesterol (HDL-c) is a well-recognized risk factor in the development of cardiovascular diseases. Associated gene variants for low HDL-c have already been demonstrated in various populations. Such associations have yet to be established among Filipinos who reportedly have a much higher prevalence of low HDL-c levels compared to other races.

Objective. To determine the association of selected genetic variants and clinical factors with low HDL-c phenotype in Filipinos.

Methods. An age- and sex-matched case-control study was conducted among adult Filipino participants with serum HDL-c concentration less than 35 mg/dL (n=61) and those with HDL-c levels of more than 40 mg/dL (n=116). Genotyping was done using DNA obtained from blood samples. Candidate variants were correlated with the low HDL-c phenotype using chi-squared test and conditional logistic regression analysis.

Results. Twelve single nucleotide polymorphisms (SNPs) were associated with low HDL-c phenotype among Filipinos with univariate regression analysis. The variant rs1260326 of glucokinase regulator (GCKR) (CT genotype: adjusted OR=5.17; p-value=0.007; TT genotype: adjusted OR=6.28; p-value=0.027) remained associated with low HDL-c phenotype, together with hypertension and elevated body mass index, after multiple regression analysis.

Conclusion. The variant rs1260326 near GCKR is associated with low HDL-c phenotype among Filipinos. Its role in the expression of low HDL-c phenotype should be further investigated prior to the development of possible clinical applications.

Cardiovascular Diseases ; Dyslipidemias ; Genetics ; Polymorphism, Single Nucleotide

BACKGROUND Hypertension is the most common risk factor for cardiovascular disease in the Philippines. Despite the availability of antihypertensive medications that are effective, safe, and tolerated by Filipino patients, the numbers of uncontrolled hypertensives are still increasing. Several factors play in the poor control of blood pressure, particularly resistant hypertension and hyperactive sympathetic nervous system. Renal denervation therapy is a novel device that has been shown to lower blood pressure in patients with resistant and difficult-to-treat hypertension and is deemed safe in clinical trials. A Philippine Working Group composed of specialists in cardiology, hypertension, vascular surgery, and clinical epidemiology has come up with consensus statements in identifying patients who will benefit from the procedure. Locally, there is a need to have hypertension centers treating uncontrolled and resistant hypertension and offer renal denervation therapy to appropriate Filipino patients.
Blood Pressure