Experts urge ‘TLC’ for heart disease

With all the drugs available to combat the risks of heart disease, why is it still the leading cause of death in the world, especially in developing countries like the Philippines?

According to heart experts, this is because of two main factors: unhealthy lifestyle practices and non-compliance with treatment.

Dr. Ramon Abarquez Jr., emeritus professor of the University of the Philippines College of Medicine, notes that people nowadays are getting more and more exposed to unhealthy lifestyle practices, such as high-fat diet, smoking and lack of exercise. "A healthy lifestyle is a family affair. Unfortunately, many families are constantly tempted to eat in fastfoods, which serve fat-laden burgers and fries, containing artery-clogging bad cholesterol," says Abarquez.

"Most people are also leading sedentary lifestyles, which may be blamed on the fast-paced technological advancements such as cellphones, automatic home and office appliances, and computers which make everything possible without exerting so much as a finger," says Dr. Gregorio Patacsil Jr., president of the Philippine Society of Hypertension.

Both heart specialists, who are past presidents of the Philippine College of Physicians and Philippine Heart Association, agree that with the stressful and demanding jobs that most people have, exercising simply does not fit into their schedules. Most will be too mentally and emotionally exhausted that any form of strenuous physical activity is always out of the question.

To compound the problem, more and more people become smokers with a mistaken notion that it can relieve stress. "If you have risk factors and you live a lifestyle that can’t seem to care less, you are becoming more and more a walking time bomb and your life clock is definitely ticking faster," warns Abarquez, who is also an academician of the National Academy of Science and Technology.

Patacsil explains that heart disease is considered a lifestyle disease because most of its risk factors are lifestyle-dependent. "Therefore, what better way to treat it than through TLC, not tender loving care, but Therapeutic Lifestyle Changes," says Patacsil.

TLC is a set of guidelines established for the initial treatment of most heart-related diseases such as hypertension and coronary heart disease (CHD), which is the narrowing of the arteries that supply the heart with blood and nutrition. Patacsil emphasizes that this is the keystone in the treatment of most heart diseases. "Medications may not be optimally effective without TLC," he adds.

One of the major risk factors for heart disease is a high level of cholesterol. Poor dietary habits, physical inactivity and obesity contribute to this risk of heart disease. However, there are cases where TLC alone is simply not enough to lower one’s cholesterol. If the patient does not respond adequately to TLC within six to 12 weeks, the doctor usually advises drug treatment. TLC and drug treatment go hand in hand in preventing and decreasing the risk of CHD.

Statins are potent cholesterol-lowering drugs in the market today. This is a prescription product and should only be taken upon a doctor’s advice. One of the most scientifically documented drugs of this class is simvastatin. The 20,000-patient Heart Protection Study (HPS) published in the Lancet shows strong evidence that simvastatin, taken religiously for several years, cut the risks of heart attacks and strokes in the high-risk population, particularly diabetics.

Patient compliance though is a common problem in treating patients with heart disease who usually need maintenance medications for life. Cost of the medicine is recognized as a big cause of poor compliance. Therapharma, a division of Unilab, has introduced an affordable brand of simvastatin which is hoped to improve the compliance problem in statin therapy.