Deadly grip of cardiovascular diseases on Filipino families
MANILA, Philippines鈥擳hink of your loved ones 鈥� your family, friends, people you work with, or even the people in your community. Can you name someone who has suffered a heart attack or stroke?
Chances are, the answer is yes.
Heart disease and stroke have long-lasting impacts on nearly every Filipino family, leaving behind a trail of grief and loss. Yet, while heart disease remains the leading cause of death in the Philippines, the most insidious driver 鈥� high cholesterol 鈥� often goes unnoticed.
This silent killer quietly fuels heart attacks and strokes, but awareness of its deadly impact remains dangerously low, leaving countless lives at risk in a crisis that could be prevented.
Behind the statistics are lives forever changed, stories of everyday Filipinos navigating an invisible but relentless threat.
By uncovering the personal journeys of those affected, this three-part report aims to shine a light on a crisis too often ignored, and to ask the critical question: What will it take to turn the tide?
Imagine this: A 52-year-old Filipino man arrives at a hospital鈥檚 emergency room, clutching his chest in agony. He鈥檚 gasping for breath, his face pale and drenched in sweat. The pain, he says, feels like a heavy, unrelenting weight pressing down on his chest.
The medical team springs into action. His blood pressure is dangerously low, and his heart is racing at 120 beats per minute. His skin is cold and clammy 鈥� a clear sign his body is in shock. An electrocardiogram confirms their worst fear: he鈥檚 having a massive heart attack.
Tests reveal the extent of the damage to his heart. A blood sample shows his troponin levels, an enzyme released when the heart is injured, are ten times higher than normal. The situation is critical.
As he is rushed to the cardiac catheterization lab, his condition deteriorates further. His pulse fades, and his blood pressure becomes almost impossible to detect.
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Despite the doctors鈥� best efforts to save him, his heart gives out. Just one hour after stepping into the hospital, he is pronounced dead.
Based on a real-life medical case presentation, this harrowing story is all too familiar for many Filipinos. Countless families have experienced the devastating impact of cardiovascular diseases (CVDs), a silent yet deadly epidemic that continues to take lives across the country.
The World Health Organization (WHO) defines CVDs as a group of disorders that affect the heart and blood vessels. These include:
Graphics by: Ed Lustan / 黑料社
Heart attacks and strokes are among the most severe outcomes of CVDs. These events are often caused by blockages that disrupt blood flow to the heart or brain. Strokes may also result from bleeding caused by a ruptured blood vessel or clots obstructing blood flow.
A nationwide survey by the Philippine Heart Association found that among hospital-based populations, stroke accounted for 30 percent of CVD-related cases, followed by coronary artery disease (17.5 percent) and heart failure (10.4 percent).
Data from the Department of Science and Technology鈥揊ood and Nutrition Research Institute (DOST-FNRI) showed similar trends in the general population. The prevalence of CAD, cerebrovascular disease, and PAD was 1.1 percent, 0.9 percent, and 1.0 percent, respectively. These conditions collectively fall under atherosclerotic cardiovascular disease (ASCVD).
According to the American Heart Association, ASCVD occurs when fatty deposits, cholesterol, and other substances 鈥� collectively known as plaque 鈥� build-up in the artery walls.
This process, called atherosclerosis, narrows the arteries, restricting oxygen-rich blood from reaching vital organs. The result is a significantly increased risk of life-threatening events like heart attacks and strokes.
Graphics by: Ed Lustan / 黑料社
Sometimes, people may not experience any symptoms until a significant blockage occurs in the arteries due to plaque buildup. When symptoms of ASCVD do appear, they vary depending on the part of the body affected but often include:
Graphics by: Ed Lustan / 黑料社
鈥淪o, our blood vessels in the body [鈥 they鈥檙e like pipes that carry blood to different parts of the body. So if they鈥檙e like pipes, similar to those of Maynilad or Manila Water, they should be clean, they should be wide, and they should be delivering blood,鈥� explained Dr. Marc Del Rosario, head of the Cardiac Catheterization Laboratory at the Asian Hospital and Medical Center.
鈥淏ut what happens over time is that these blood vessels [鈥 develop issues for whatever reason. Over time, it鈥檚 like rust accumulating in your pipes 鈥� you build up cholesterol plaque in the artery,鈥� he added.
A paper titled Coronary Heart Disease (Sakit sa Puso) in the Philippines: A Guide to Patient Education, Prevention, and Treatment published by Stanford Medicine underscores the gravity of the situation. It highlights that many CVD cases in the Philippines are often detected too late, with fatal outcomes.
鈥淭his mode of presentation of a heart attack is common in the Philippines, where people with unrecognized and undiagnosed preventable cardiovascular diseases often present late in their disease,鈥� the paper stated, referring to the case presentation.
CVDs remain the leading cause of death worldwide, claiming an estimated 17.9 million lives annually 鈥� 32 percent of all deaths globally. According to WHO, 85 percent of these deaths are due to heart attacks and strokes.
Alarmingly, over three-quarters of CVD-related deaths occur in low- and middle-income countries, underscoring the urgent need for improved prevention, diagnosis, and treatment.
In the Philippines, ASCVD-related conditions remain the deadliest condition, claiming countless lives annually. From January to June 2024 alone, ischemic heart disease 鈥� another term for CAD or CHD 鈥� accounted for 49,577 deaths, representing 19.9 percent of all fatalities nationwide.
Cerebrovascular diseases ranked third, with 25,186 fatalities (10.1 percent), while other heart diseases placed ninth, causing 6,935 deaths (2.8 percent).
Graphics by: Ed Lustan / 黑料社
Even at the height of the COVID-19 pandemic, ischemic heart disease remained the leading cause of death, with 125,913 cases in the first half of 2021 and 113,242 cases during the same period in 2022.
According to Dr. Del Rosario, ASCVD is particularly concerning due to its ability to affect various parts of the body.
鈥淭here are three common sites,鈥� he said. 鈥淐oronary artery disease (CAD) impacts the heart, peripheral artery disease (PAD) affects the legs, and cerebrovascular disease targets the brain. When a vessel gets blocked or ruptures, that鈥檚 when a [heart attack or] happens.鈥�
While ASCVD events like heart attacks and strokes are often deadly, Dr. Janet Chavez, a medical advisor at Novartis Healthcare Philippines, Inc., emphasized that not all cases result in death.
However, she cautioned that surviving such an event can leave lasting consequences, with the disease potentially affecting a patient’s quality of life for years to come.
Beyond the physiological effects of ASCVD, the condition deeply affects patients’ emotional well-being and mental health, often leaving scars that go unnoticed.
In a Facebook group for Filipino stroke survivors, one poignant post asked, 鈥淲ho feels sad [and] lonely after [they had] stroke?鈥� The question resonated with over a hundred replies, most 鈥� if not all 鈥� expressing struggles with sadness and clinical depression after their first ASCVD-related event.
Mary, not her real name, shared her experience during a hospital stay for a thrombectomy 鈥� a procedure to remove a blood clot from a blood vessel.
鈥淢y [doctor] always finds me crying during her rounds. [That鈥檚 when] she gave me antidepressants. [Four] years post stroke I鈥檓 still on it,鈥� she wrote.
Another survivor echoed this sentiment: 鈥淸T]here are times that I feel sad and lonely, whenever I get to see that I cannot normally do the things I used to do and go out where I want to be.鈥�
Graphics by: Ed Lustan / 黑料社
In another post, Harry, not his real name, reflected on the emotional toll his stroke in 2023 had on himself and his family. He revealed that the event created rifts within his relationships.
鈥淢y sibling scolds me and blames me for what happened and why I had a stroke… they said I was a burden to them.鈥�
Though his sibling鈥檚 words were harsh and hurtful, Harry found strength in the adversity. Rather than let it break him, he used it as motivation to rebuild his life.
鈥淪o I pushed myself to move forward and return to my normal life because I still needed to work and survive. I exercised by walking every night and followed everything my physical therapist told me to do,鈥� he said.
鈥淎fter two months, I was able to go back to my house and live alone. It was lonely, yes, but I had to endure it. My left arm and hand are still not moving normally, but that鈥檚 okay, life goes on. I need to stay strong,鈥� he added.
While clinical depression is common among patients following an ASCVD event 鈥� understandable given the profound disruption strokes and heart attacks bring to daily life 鈥� research also suggests that depression itself can be a contributing risk factor for ASCVD.
A study published by the US Centers for Disease Control and Prevention (CDC) explored the link between depression and CVD risk, focusing on two key areas: the 10-year ASCVD risk for people aged 40 to 79 and the lifetime CVD risk for younger adults aged 20 to 39.
While the connection between depression and heart disease is well-documented, the researchers noted that few studies in the US have quantified this risk using standard primary care assessments, particularly for younger adults who are not routinely screened for CVD risk.
The findings revealed that both mild and major depression significantly increase the risk of ASCVD in older adults and dramatically elevate lifetime CVD risk among younger individuals.
For adults aged 40 to 79, women with mild or major depression had a 15 percent to 27 percent higher 10-year ASCVD risk compared to those without depression. Men in the same age group saw a 12 percent to 14 percent increase.
The impact of depression was even more striking in younger adults aged 20 to 39. Women with major depression were 60 percent more likely to face high lifetime CVD risk, while men with major depression faced a 40 percent higher risk compared to their peers without depression.
Another paper published in the Journal of the American Medical Association (JAMA) highlighted that major depressive disorder is not only a risk factor for developing coronary heart disease in otherwise healthy individuals but also worsens cardiovascular outcomes in those with existing heart conditions.
鈥淒epression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 outpatients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated,鈥� explained Dr. Mary Whooley, a primary care physician and author of the paper titled Depression and Cardiovascular Disease: Healing the Broken-Hearted.
鈥淚t is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life,鈥� Whooley added.
(NEXT: Financial burden, ASCVD risk factors, high bad cholesterol: a silent threat)
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鈥攕o no Filipino heart is lost too soon.
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