Philippine Heart Association releases updated guidelines for Coronary Artery Disease

Chances are, you know someone who has died of a heart attack. That's because heart attacks are the results of coronary artery disease (CAD), which is the most common heart disease there is—and the Philippine Heart Association (PHA) has now released a 2014 edition of its guide on how to treat a variety of heart diseases in the Philippine setting.

 

Silent killer has claimed more lives than Yolanda

 

According to the most recent data survey the PHA could get, the disease claimed 170,000 Filipino lives in 2009.

 

“That is like, 20 times the mortality rates in Yolanda,” said PHA president Joel Abanilla at the press launch at Oakwood Premier on Nov. 27. “But these ones are happening silently all over the country. We don't see the dramatic effect like in a castastrophe from a storm or tsunami, but it is there and it has to be addressed.”

 

“We know that the top two killers in the country are cardiovascular diseases—and most of the [victims] will die of heart attack,” Abanilla added. “This [the guideline] should be in the hands of all frontliners who will manage the cardiovascular problems in their own localities.”

 

The 'frontliners' mentioned are medical personnel who work in the emergency room.

 

Dr. Victor L. Lazaro, Chairman of the PHA Council behind the CAD guidelines, defined coronary artery disease as such:

 

“Our heart has arteries. The main function of the coronary arteries is to bring blood to the muscles of the heart. Blood provides oxygen and nutrients to the heart. If you cut those off, that will become a problem,” he said.

 

Lazaro further explained that CAD is caused by plaque building up along the inner walls of the arteries of the heart, which narrows the lumen of the arteries and reduces blood flow.

 

He said that as people age, cholesterol tends to clog the blood vessels. “Pag 'di natin inaalagaan ang ating sarili, babara ito sa arteries.”

 

Symptoms include chest pains, shortness of breath, and the tendency to get tired easily.

 

But Lazaro cautioned that heart attacks can also happen to asymptomatic or seemingly health people (which he called silent eschemia). “You may not know you have heart disease because you feel strong, but it’s possible,” he said.

 

Lazaro also identified the risk factors, both modifiable and non-modifiable.

 

 

He said that clinics may also check for hypertension, diabetes mellitus, high cholesterol, mental stress or depression, as those who suffer these are more prone to CAD.

 

Modifiable factors, which Lazaro stressed is where prevention should be focused. These include having a smoking habit, leading a sedentary lifestyle, or being obese.

 

Changes, importance, dissemination

 

Abanilla assured the audience that international medical bodies and associations have also reviewed these guidelines in order to see if they were applicable to the Philippine setting.

 

“Guidelines are recommendations that have undergone the scrutiny of a panel of experts. It was tenaciously worked on by our young cardiologists, who went and took with them cardiologists who are considered experts in the field," he said.

 

He continued, “A guideline is just a roadmap. There will be decisions along the process that you will have to make, but at least you will not be confused. With the guideline, there is a better assurance na tama ang gagawin sa inyo kung magka-heart attack kayo. We will take the challenge of educating as many as we can.”

 

Abanilla cautioned physicians that, “Each individual patient has nuances, so sometimes you will encounter situations that are not addressed by the guideline. Pero rare yun. Your own background and practice will indicate what to take. But the most important things to do are there.”

 

Lazaro said that the guidelines are important in assisting physicians in making clinical decisions in the management of CAD, as well as improving the quality of care of Filipino patients with CAD.

 

He said that with regard to dissemination, the PHA plans to print and distribute the booklet and hold lectures and presentations for different medical groups. Their target area is the entire country, as it was deemed important even for general physicians, nurses, and paramedics to be able to assess what to do at their level.

 

The guidelines contain information for medical professionals at different levels of expertise, ranging from paramedics to specialists.

 

Among the changes from the 2009 version are medications such as anti-platelets and heart rate-controlling medicines; new machines, echo-cardiography; and the tailoring to Philippine use.

 

“Foreign guidelines have lots of equipment and accessories compared to us,” said Lazaro. “We make do with what we have and we don’t copy the international guidelines—this is solely ours.” — JDS, GMA News