Ischemic heart disease remains the leading cause of death in the Philippines, according to data from the Philippine Statistics Authority.

But behind many of these fatal heart conditions lies a far more common and often overlooked health problem — hypertension or high blood pressure.

Often called a “silent killer,” hypertension develops gradually and usually without obvious symptoms.

By the time warning signs appear, the condition may have already caused serious and irreversible damage to the heart, brain, kidneys, and blood vessels.

The scale of the problem in the Philippines is alarming.

Based on the Philippine Heart Association’s survey on hypertension, four out of every 10 Filipinos are hypertensive, yet only about half are aware they have the condition.

For cardiologist Dr. Allan Gumatay of Medical Center Parañaque, low awareness is only part of the problem. He says many Filipinos also struggle with misconceptions about maintenance medication, health behavior and financial limitations that prevent them from properly managing the disease.

“Ang napansin natin sa ating mga pasyente, una, ‘pag wala kasing nararamdaman, nakakatamad talaga uminom. Nagdudunong-dunungan tayo minsan. ‘Pag normal ang [blood pressure], hindi iinom ng gamot,” Gumatay said.

Many patients, he explained, mistakenly treat maintenance medicines as temporary treatment instead of long-term therapy designed to continuously regulate blood pressure.

“Kapag once a day ang gamot mo, kunyari, ininom mo siya ng alas-7:00 ng umaga, so by tomorrow ng 7:00 a.m., pawala na ‘yung effect ng gamot. Kaya dapat sundan mo na ulit ng bagong dose. Kaya siya maintenance.”

Hypertension occurs when the force of blood pushing against artery walls remains consistently high.

Over time, this excessive pressure damages blood vessels and forces the heart to work harder, increasing the risk of heart attacks, strokes, kidney disease, and heart failure.

Experts stress that hypertension is highly individualized.

Factors such as age, genetics, weight, diet, stress levels, lifestyle, and existing medical conditions all influence how the disease develops and how it should be treated.

Because of this, Gumatay says that antihypertensive drugs are not “one-size-fits-all” medications.

Some medicines may work effectively for certain patients but not for others, making medical consultation and proper testing crucial before starting treatment.

Health Secretary Teodoro Herbosa also reminded the public that controlling blood pressure remains one of the most effective ways to prevent strokes and heart attacks.

“Inumin ito ayon sa payo ng inyong doctor. Huwag ihinto kung walang abiso ng doctor dahil maaring maapektuhan kung maantala ang maayos na blood pressure kung biglang tatanggalin ang maintenance ng walang abiso ng doktor,” Herbosa said in a recorded message.

One of the dangers of hypertension is that symptoms often appear only when complications have already developed. Headaches, dizziness, chest pain, or shortness of breath may indicate that damage is already occurring.

Despite receiving treatment, many patients still fail to achieve safe blood pressure levels.

Data show that six out of every 10 hypertensive patients undergoing treatment are still considered “uncontrolled,” underscoring the importance of strict adherence to medication and lifestyle changes.

A 2021 study also showed that hypertension can begin as early as 12 years old, although cases sharply increase beginning at age 30 and continue rising among older populations.

Doctors warn that every moment blood pressure remains elevated contributes to gradual damage within the body.

These injuries to arteries and organs can accumulate silently over years and may eventually become irreversible.

Beyond its health consequences, hypertension also carries serious economic costs.

Complications from uncontrolled blood pressure can reduce productivity, force patients to miss work, and limit daily activities, particularly among Filipinos in their most economically productive years.

Gumatay also clarified common misconceptions about what is considered “normal” blood pressure.

According to current standards, a healthy blood pressure reading is below 120 over 80 millimeters of mercury (mmHg). Readings around 120 over 80 may already be considered elevated and should be monitored closely.

The good news, experts say, is that early-stage hypertension can still be managed and sometimes reversed through lifestyle changes.

“Kung Stage 1 lang ang high blood mo, kaya mong i-normalize pa rin ‘yun with normal ways. ‘Yung 140 over 90 mo, kung magbabawas ka ng alat forever, kung mag-aayos ka ng timbang mo, mame-maintain mo siya. Kung mag-e-exercise ka, kumain ng gulay prutas, ‘yung epekto na ‘yun, mag-130, 120 ang blood pressure mo,” Gumatay explained.

Reducing salt intake, maintaining a healthy weight, exercising regularly, avoiding smoking, limiting alcohol consumption, and eating more fruits and vegetables remain among the most effective ways to lower blood pressure naturally.

Still, doctors note that age and genetics can also make hypertension unavoidable for some individuals.

In such cases, consistent medication, routine monitoring, and healthier lifestyle choices become even more essential to prevent life-threatening complications.

For many Filipinos, hypertension may remain invisible for years.

But experts warn that ignoring it could allow silent damage to continue until it becomes deadly. (ABS-CBN News)