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PHA Healthy Lifestyle Advocacy Philippine Heart Association (PHA) • A non-stock, non-profit organization founded on March 26, 1952 • Initial membership of 26 physicians 50 years ago • Currently with a membership of 1,500 cardiologists nationwide PHA Vision 2012 The PHA shall be a leading organization of cardiovascular specialists in the Asia Pacific region in the prevention and management of cardiovascular diseases. PHA Mission 2012 The PHA is an organization of cardiovascular specialists and lay members that ensures accessible, affordable and quality cardiovascular education and care for every Filipino. Heart disease can be a silent, crippling and fatal traitor. Heart disease can be a silent, crippling expensive and fatal traitor. TEN LEADING CAUSES OF MORBIDITY No. & Rate/100,000 Population PHILIPPINES, 2001 (DOH Database) CAUSE NO. RATE 1. Diarrheas 845.526 1085.0 2. Bronchitis/Bronchiolitis 694,836 891.7 3. Pneumonias 652,585 837.4 4. Influenza 499,887 641.5 5. Hypertension 318,521 408.7 6. TB Respiratory 110,841 142.2 7. Diseases of the Heart 47,040 60.4 8. Malaria 40,543 52.0 9. Measles 24,494 31.4 10. Chickenpox 24,359 31.3 Ten Leading Causes of Mortality by Sex/Number, Rate/100,000 Population & Percentage, Philippines, 2000 (DOH Database) Cause Male Female Total Number Rate % of Total Deaths 1. Diseases of the heart 34,356 26,061 60,417 79.1 16.5 2. Diseases of the vascular system 27,197 21,074 48,271 63.2 13.2 3. Malignant Neoplasm 19,597 16,817 36,414 47.7 9.9 4. Pneumonia 16,549 16,088 32,637 42.7 8.9 5. Accidents 26,009 6,346 32,355 42.4 8.8 6. Tuberculosis, all forms 18,590 8,967 27,557 36.1 7.5 7. Chronic obstructive pulmonary diseases and allied conditions 10,770 5,134 15,904 20.8 4.3 8. Certain conditions originating in the perinatal period 9,083 6,015 15,098 19.8 4.1 9. Diabetes Mellitus 5,147 5,600 10,747 14.1 2.9 10. Nephritis, nephritic syndrome and nephrosis 4,642 3,321 7,963 10.4 2.2 Nearly 30% of all deaths in the Philippines are due to cardiovascular causes. th 6 NNHES 2003-2004 6th NNHES 2003-2004 • 6th NNHeS Survey • Overview of nutrition-related and lifestyle diseases and risk factors • Adults >20 yrs • Collaboration with 14 medical societies, FNRI and DOH Prevalence of various risk factors % 40 35 30 25 20 15 10 5 0 34.8 24.9 17.4 8.5 4.6 es et b ia D y H ho rc e p ia em l ro te s le n re ur C g in ok m ts y H ns te r pe n io s be O it y M (B I> ) 25 Dans A. et al National Nutrition and Health Survey (NNHeS): Atherosclerosis-related Diseases and Risk Factors. Phil. J. Int. Med. 43:103-115, May-June, 2005 Proportion of Adults with at least One Risk Factor for Atherosclerosis Age Overall % (SE) Males % (SE) Females % (SE) 20-29 83.3 (1%) 83.4 (2%) 83.3 (2%) 30-39 90.3 (1%) 88.9 (2%) 92.2 (2%) 40-49 94.9 (1%) 93.9 (1%) 96.1 (1%) 50-59 94.7 (1%) 92.9 (2%) 96.1 (1%) 60-69 95.2 (1%) 93.1 (1%) 96.8 (1%) 70 & over 95.6 (1%) 92.4 (1%) 97.8 (1%) Total 90.3 (1%) 88.9 (1%) 91.8 (1%) Prevalence of Risk Factors • 90% of adults surveyed (20 yrs and above) have at least one risk factor • With approximately 82 million Filipinos (54.4% 20 yrs and above), this translates to >44 million Filipinos MAIN Conclusions 1. Prevalence of disease obtained in percent. 2. 90% of adults have at least 1 risk factor. 3. Diabetes, Hypertension, hypercholesterolemia, Obesity and Smoking are enough to explain majority of CVD/CAD deaths in the country. 4. Smoking causes the most number of deaths. 5. We need a comprehensive multidisciplinary approach to prevention. The Concept of the Risk Factor • Predisposing situation, condition, trait • Increases the likelihood of the medical condition Major Risk Factors for Coronary Heart Disease • • • • • • • Smoking Diabetes Hypertension Cholesterol Age Obesity Physical Inactivity “Comprehensive Healthy Lifestyle Advocacy and Health Promotion Campaign in the Prevention of Cardiovascular Diseases and Related Chronic Diseases” PHA Newsbriefs Nov 2001-Feb 2002 “Mag – Healthy Lifestyle Tayo” The National Healthy Lifestyle Campaign • The National Healthy Lifestyle is a collaborative campaign project of the PHA, the Department of Health and the Healthy Lifestyle Coalition. • Mag-HL (Healthy Lifestyle) Tayo aims to underscore the need for Filipinos to practice healthier lifestyle. It also aims to raise the consciousness of policy makers to provide the Filipinos an environment supportive to healthy lifestyle practices. Mag HL (Healthy Lifestyle Tayo) Coalition • • • • • • • • • • Department of Health (DOH) Philippine Heart Association (PHA) Food Nutrition Research Institute, DOST (FNRI) Philippine Lipid Society (PLS) Philippine Society of Hypertension (PSH) Osteoporosis Society of the Phils (OSP) National Asthma Movement (NAM) Tobacco Free Philippines (TFP) Framework Convention Alliance on Tobacco Control of the Phils (FCAP) Stroke Society of the Philippines (SSP) • Philippine Association for the Study of Overweight & Obesity (PASOO) • UP College of Human Kinetics (UP-CHK) • UP College of Nursing (UPN) • Oversight Committee on Diabetes (OCD) • Philippine Cancer Society (PCS) • Philippine Diabetes Association (PDA) • Nutritionist-Dietician Association of the Phils (NDAP) • Philippine College of Chest Physicians (PCCP) • Philippine Pediatric Society (PPS) Strategies to Address the CVD Menace • Lifestyle Modification – – – – – – Smoking cessation Weight reduction Reduction of sodium intake Consumption of fruits/vegetables Moderation of alcohol intake Exercise • Pharmacologic Management – – – – Control of hypertension Lipid-lowering Diabetes control Preventive drugs Weight Management • Goal: achieve and maintain desirable BW (BMI 18.5-24.9 kg/m2) • When BMI is >25 kg/m2, waist circumference should be <35 inches in men, <31 inches in women (for Filipinos) Physical Activity • At least 30 minutes of moderate-intensity exercise on most (and preferably) all days of the week • Moderate intensity: 4060% of maximum capacity – brisk walk 15-20 min per mile Dietary Guidelines • Advocate consumption of a variety of fruits, vegetables, grains, low fat or nonfat dairy products, fish, legumes, poultry and lean meat • Modify food choices to reduce saturated fat (<10% of calories, cholesterol <300 mgs/dl) and trans-FA by substituting grains and PUFA from fish, vegetables, legumes and nuts Dietary Guidelines • Limit salt intake (<6 mg/day) • Limit alcohol intake (<2 drinks/day in men, <1 drink/day in women) among those who drink Smoking • Clear, strong and persuasive manner in advising cessation • Referral to special programs or pharmacotherapy • Avoidance of second-hand smoke Blood pressure control • Goal: <140/90 mm Hg • <130/85: if with renal insufficiency or heart failure is present • <130/80: if diabetes is present Identified Priority Advocacy Activities • Quad-media campaign • Partnership with LGUs and other private organizations • Annual thematic advocacy events (Heart Month, World Heart Day) • Joint Declaration on Healthy Lifestyle and Healthy City • Healthy Lifestyle in schools • Healthy Heart Cookfest and book 5 – Point Advocacy Thrusts • Greater public awareness • Information dissemination • Maximum utilization of partnerships and alliances • Evaluation of resources and sources • Heighten the momentum of high impact programs The Philippine College of Physicians wishes to acknowledge the following for their invaluable contribution in the preparation of this module Philippine Heart Association (PHA)