Heart failure cases rise as major health concern

The Philippine Heart Association (PHA) has positioned heart failure (HF) as a pressing and escalating public health crisis, arguing that it is no longer an uncommon or late-stage diagnosis but a widespread and preventable issue. During Heart Failure Awareness Week, held April 14 at Comer Noche in Mandaluyong City, the PHA’s Council on Heart Failure urged immediate intervention, stressing that early detection—through education campaigns, improved clinic networks, and public outreach—could significantly reduce both human suffering and healthcare costs.

Why heart failure is worsening in the Philippines

Heart failure impacts roughly 64 million people globally, often developing gradually over years rather than emerging suddenly. In the Philippines, registry data indicates the condition affects about 10.4 percent of the population, a figure that shows both underdiagnosis and rising risk factors. Hypertension control rates remain critically low at 38.6 percent, while nearly 31 percent of adults smoke. Rising rates of diabetes, obesity, and high cholesterol further compound the risk, creating an ideal environment for HF development.

Unlike acute illnesses, HF symptoms—such as shortness of breath, persistent fatigue, swelling, or irregular heartbeat—are frequently attributed to stress or aging. By the time patients seek medical attention, irreversible damage may have already occurred. The PHA has strengthened grassroots awareness through its ongoing Heart Failure Caravan, which has already reached Iloilo, Cagayan de Oro, Zamboanga, Clark, Baguio, and Tacloban, with upcoming stops planned in Bicol, Cebu, and other regions. The initiative aims to bring education, screening, and awareness directly to communities across the country.

Dr. Erlyn Demerre, chair of the PHA Council on Heart Failure, emphasized that public education is the most effective defense against the condition. “Education is the strongest pillar, when patients, healthcare professionals, and communities are informed, care improves and stigma fades,” she stressed. The association’s advocacy for dedicated HF clinics, specialized outpatient centers focused on monitoring, medication management, and early intervention, forms a central part of this strategy. These facilities serve as continuity points, reducing hospital readmissions and slowing disease progression.

Financial barriers remain a major obstacle. For instance, a novel therapy for hypertrophic cardiomyopathy (HCM), a condition closely linked to HF, costs significantly less in Singapore than in the U.S. or locally. Patients like Chef Heny Sison, a well-known baker diagnosed with HCM after a stress test revealed thickened heart muscle, face substantial access challenges. “I used to do everything hanggang mapagod ako,” she admitted. “Now, I trust my team.” Her experience shows how full care, spanning cardiologists, rehabilitation specialists, and support networks, is essential for managing symptoms and restoring daily function.

The PHA’s efforts extend beyond clinics. Continuity of care for HF patients is important through cardiac rehabilitation programs, which combine supervised exercise, education, and lifestyle modification to improve functional capacity and quality of life. However, scaling these initiatives requires consistent funding and infrastructure.

A condition mistaken for stress, or ignored entirely

Heart failure is often described as a “silent epidemic” because its progression is gradual, and early signs are easily overlooked. Persistent fatigue, leg or abdominal swelling, and breathing difficulties during sleep are common indicators, but many dismiss them as normal aging or stress. By the time patients recognize a problem, their heart’s pumping function may already be severely impaired.

The condition frequently overlaps with diabetes, kidney disease, and other chronic illnesses, complicating long-term management. Without effective control of risk factors like hypertension or high cholesterol, HF worsens over time. The Philippines’ poor management rates, particularly for hypertension, exacerbates the issue. Smoking, unhealthy diets, and sedentary lifestyles further accelerate damage, making prevention an urgent but overlooked priority.

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Chef Sison’s story illustrates how HF disrupts lives. Initially attributing her shortness of breath to aging, she only discovered her HCM diagnosis during a routine checkup. The shock, “Parang bumagyo ‘yung utak ko,” she recalled, was compounded by uncertainty: Would her career end? Would she have to slow down? For high achievers, the psychological impact of HF can be as severe as the physical symptoms. Yet her journey also demonstrates that with a cohesive care team, patients can adapt and maintain quality of life. Medication, lifestyle adjustments, and specialist support allowed her to continue baking while managing her condition.

HF is more than stress or “pagod lang.” HF develops gradually as the heart loses its ability to pump blood efficiently. Because of this slow progression, early symptoms are often dismissed. These include persistent shortness of breath, easy fatigability even with minimal exertion, swelling of the legs, ankles, or abdomen, unexplained rapid weight gain due to fluid retention, persistent cough or wheezing, difficulty lying flat during sleep, and episodes of rapid or irregular heartbeat.

The PHA’s advocacy for HF clinics aligns with international standards, where structured outpatient care reduces hospitalizations and improves survival rates. These centers provide regular monitoring, medication optimization, and patient education, critical steps in preventing deterioration. However, expanding such services nationwide faces practical and financial hurdles. Rural areas, in particular, lack access to specialists and diagnostic tools, leaving many without timely care.

While the PHA’s initiatives, including the Heart Failure Caravan and clinic expansions, offer solutions, addressing the broader issue requires systemic changes. Strengthening primary care, improving risk factor management, and increasing public awareness are necessary. The association’s campaign, centered on “Educate, Innovate, Empower”—reflects the urgency: HF is preventable, but only if patients, doctors, and policymakers intervene before irreversible damage occurs.

Addressing the future of heart failure in the Philippines

The PHA’s work focuses on expanding HF clinics and enhancing community outreach to tackle risk factors like smoking and hypertension. However, progress depends on more than medical solutions. Cultural perceptions of illness, where symptoms are often dismissed as temporary, must shift. Public campaigns, such as the Heart Failure Caravan, play a role, but lasting behavior change requires education in schools, workplaces, and media.

Funding remains a critical barrier. Advanced treatments, including the HCM medication Chef Sison depends on, are expensive, and insurance coverage for chronic conditions is inconsistent. The PHA’s push for sustainable rehabilitation programs also assumes stable financial support, which is unlikely without government or private investment. Without these resources, high-risk patients, especially in low-income communities, will continue to face delays in diagnosis and treatment.

If current trends persist, the HF burden will rise alongside increasing rates of diabetes and obesity. The PHA’s work is vital, but its effectiveness depends on broader healthcare reforms. The challenge now is whether the association’s efforts can bridge the gap between awareness and action, or if heart failure will remain an unaddressed crisis.

The focus remains on core solutions: early detection, expanded clinic networks, and a national effort to treat HF as a preventable condition. The PHA’s message is direct: immediate action is required.