Ischemic heart disease (IHD) remains the most common cause of death while cerebrovascular disease (CVD) is the third most common in the Philippines. IHD and CVD represent complications resulting from prevalent non-communicable diseases (NCDs) and risk factors which present important opportunities for primary and secondary prevention.

This study aimed to pilot a sustainable multisectoral approach for community-based screening and management of cardiovascular (CV) risk factors and determine the effects of a multisectoral collaboration approach on the rate of screening, prevalence and control rates for selected risk factors.

This is a quality improvement project that determines the baseline prevalence and control rates of CV risk factors followed by intense screening efforts with support from private partnerships. The project's core components are: (a) capacity building (b) information dissemination; (c) service provision; and (d) health monitoring. Rates of screening, prevalence and control were monitored over a two-year period.

A total of 94,125 patients were screened through the ONE Cavite Project over two years (January 2021 to December 2022). A total of 61,271 were newly identified as having hypertension (65.1%), 24,069 diagnosed with diabetes mellitus type 2 (25.6%), 29,257 diagnosed to have dyslipidemia (31.1%) and 13,204 smokers (14.0%) were identified.

Intensification of screening was successful in improving identification of individuals with NCDs. The impact of continued educational support for both providers and patients in this study reaffirmed its role as a central component of NCD diagnosis, management and prevention.

Hypertension ; Diabetes Mellitus ; Dyslipidemias ; Myocardial Ischemia ; Primary Prevention

Ischemic heart disease (IHD) remains the most common cause of death while cerebrovascular disease (CVD) is the third most common in the Philippines. IHD and CVD represent complications resulting from prevalent non-communicable diseases (NCDs) and risk factors which present important opportunities for primary and secondary prevention.

This study aimed to pilot a sustainable multisectoral approach for community-based screening and management of cardiovascular (CV) risk factors and determine the effects of a multisectoral collaboration approach on the rate of screening, prevalence and control rates for selected risk factors.

This is a quality improvement project that determines the baseline prevalence and control rates of CV risk factors followed by intense screening efforts with support from private partnerships. The project's core components are: (a) capacity building (b) information dissemination; (c) service provision; and (d) health monitoring. Rates of screening, prevalence and control were monitored over a two-year period.

A total of 94,125 patients were screened through the ONE Cavite Project over two years (January 2021 to December 2022). A total of 61,271 were newly identified as having hypertension (65.1%), 24,069 diagnosed with diabetes mellitus type 2 (25.6%), 29,257 diagnosed to have dyslipidemia (31.1%) and 13,204 smokers (14.0%) were identified.

Intensification of screening was successful in improving identification of individuals with NCDs. The impact of continued educational support for both providers and patients in this study reaffirmed its role as a central component of NCD diagnosis, management and prevention.

Hypertension ; Diabetes Mellitus ; Dyslipidemias ; Myocardial Ischemia ; Primary Prevention

BACKGROUND

Blood pressure (BP) is a vital sign that is essential in the management of hypertension, thus, there is a need for accurate measurement of BP. This will allow for proper diagnosis and management of hypertension preventing cardiovascular morbidity and mortality among Filipino patients.

METHODOLOGY

This validation study utilized the US Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) protocol for BP monitors. A total of eighty-five (85) participants had their BP measured using both the HEM 7156 and a validated aneroid sphygmomanometer. The same-sequential BP measurement was recommended to be used and a total of nine readings were collected per individual. The mean average of BP and standard deviation were extracted from the measurements. The AAMI/ESH/ISO recommends the use of certain criteria for individual BP readings (criterion 1) and individual participants (criterion 2). Appropriate statistical analysis was used for other demographic data.

RESULTS

The participants had an average age of 34 years, more than half were females, and not diagnosed with hypertension. Individuals who were diagnosed with hypertension had no other comorbidities and were on single pill only. The average arm circumference was 26.9 cm. Blood Pressure (BP) readings were adequate based on the protocol. Validity results showed that for criterion 1, systolic blood pressure (SBP) difference was 3.4 ± 7.4 mmHg, while diastolic blood pressure (DBP) was 2.0 ± 8.0 mmHg. The results for criterion 2 showed for SBP was 3.3 ± 5.3 mmHg, while DBP was 1.9 ± 6.6 mmHg. The results satisfied a passing grade on the validation protocol set by the AAMI/ESH/ISO.

CONCLUSION

This study showed that OMRON HEM 7156 is validated as a BP apparatus and may be recommended for Philippine use.

Human ; Hypertension

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

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

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

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