Introduction: The American College of Cardiology/American Heart Association (ACC/AHA) revised the thresholds for the definition and treatment of hypertension that was recommended by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) while the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure retained their previous classification but revised the recommendations for diagnosis and treatment. The impact of these changes in our setting is uncertain. This study aims to compare the prevalence of hypertension using the three proposed criteria in a primary preventive setting. Methods: This is a cross-sectional analytical study using data at the Primary Preventive Cardiology Clinic of the Philippine Heart Center from January 1, 2002 to December 31, 2017. Results: There were 2,082 patients in this study. The mean age is 57.1±10.9 years with a female predominance (72.5%). Most of the patients were married (67.3%, 1,401) and unemployed (67.1%, 1,398). Comorbid illnesses include dyslipidemia (48.2%) and type 2 diabetes mellitus (20.3%). The prevalence of hypertension using the JNC 7 and the 2018 ESC/ESH blood pressure (BP) classification was 56% (n=1,167). When the 2017 ACC/AHA BP classification was applied, there was a significant increase in the prevalence of hypertension to 80.3% (n=1671) (p<0.001) demonstrating an absolute increase of +24.2%. Conclusion The study shows a high prevalence of hypertension which further increased when the 2017 ACC/AHA BP classification was applied This can impose a significant public health burden that needs to be addressed to prevent or decrease hypertension-related complications. Use of the new guidelines may affect diagnosis and treatment of hypertension with potential cost implications.
Hypertension ; Prevalence ; Primary Prevention

INTRODUCTION: Obesity has been linked to the development of type 2 diabetes mellitus (T2DM) and cardiovascular diseases. This study primarily aims to determine the prevalence of obesity among the Filipino patients in our institution since there have been no previous studies on this subset of patients. METHODS: A cross-sectional analytical study of 2,078 patients at the Primary Preventive Cardiology Out-Patient Clinic of the Philippine Heart Center (PHC) was done from January 1, 2002 to December 31, 2017. The prevalence of obesity was determined using the World Health Organization (WHO) and Asian classification. Factors associated with obesity were determined using binary logistic regression analysis. RESULTS: A majority of the patients were females (1499, 71.14%) with a higher mean age compared to the male patients (57.67±10.5 vs 55.66±11.8, p<0.001). Hypertension (68.5%), coronary artery disease (37.1%) and T2DM (20.3%) were the most common co-morbid illnesses in both genders. The mean body mass index (BMI) was 25.8±4.3 kg/m2 for the female patients while it was 25.2±4.1 kg/m2 for the male patients (p<0.001). The prevalence of obesity using the WHO and Asian classifications was 15% (n=312). Compared to the Asian criteria, there were significantly more patients classified as having normal weight (44.09% vs 24.95%, p<0.001) and overweight (37.98% vs 19.13%, p<0.001) using the WHO classification. Pre-obesity, an additional criterion of the Asian classification which was not adopted by WHO was seen in 37.98% of the patients. On multivariate analysis, female gender (OR 1.31, 95% CI [1.08-1.59)] p=0.006) and T2DM (OR 1.25, 95% CI [1.01-1.56], p=0.42) were significant factors associated with obesity while age (OR 0.98, 95% CI [0.98-0.99], p<0.001) was protective of obesity. CONCLUSION: The prevalence of obesity in our cohort was consistent with the worldwide prevalence reported by the WHO which underscores the need for effective weight management programs and primary preventive strategies 7to lower the prevalence and obviate the development of complications related to obesity. Female gender and T2DM were significant factors associated with obesity, while age was a significant protective factor of obesity.
Overweight ; Obesity ; Primary Prevention