Hypertension: Why prevention and early treatment save lives

Hypertension may be silent, but its consequences are not. Early detection and timely treatment can prevent heart attacks, strokes, and kidney failure.

As the country observes Philippine Heart Month, it bears repeating that high blood pressure or hypertension is the single most important risk factor for heart disease and stroke, two of the leading causes of death among Filipinos. Often called the “silent killer,” hypertension typically has no symptoms, yet its consequences can be devastating. Left undetected and uncontrolled, it can lead to heart failure, kidney disease or kidney failure, vision loss, and erectile dysfunction, among other complications.

Hypertension develops due to a mix of non-modifiable and modifiable risk factors. These include family history and advancing age, as well as physical inactivity, an unhealthy diet, overweight or obesity, smoking, and chronic kidney disease. Because many of these risks are preventable or manageable, hypertension is not just a medical condition, it is a public health issue that demands early action.

The scale of the problem is sobering. The most recent Philippine Heart Association survey, PRESYON-4, found that nearly four in 10 Filipinos (37%) have hypertension. Alarmingly, only about half (52%) were aware they had the condition. Among those diagnosed, 22% were smokers, 37% were overweight, and 5% had diabetes. Even more concerning, six out of 10 hypertensive respondents who were already taking maintenance medications still had uncontrolled blood pressure, placing them at continued risk for heart attack and stroke.

Hypertension is diagnosed by measuring blood pressure on two or more separate occasions in a clinic or hospital setting. Normal blood pressure is below 120/80 mm Hg. The 2020 Philippine Clinical Practice Guidelines of the Philippine Society of Hypertension define hypertension as a blood pressure reading of 140/90 mm Hg or higher, while readings between 120-139/80-99 were previously classified as “prehypertension” or borderline hypertension.

Globally, however, there has been a shift toward earlier intervention. In August 2025, the American Heart Association and the American College of Cardiology released updated guidelines emphasizing prevention and earlier treatment to reduce long-term cardiovascular risk. Under these guidelines, blood pressure of 120-129/less than 80 is considered “elevated,” while readings of 130-139/80-89 are already classified as stage 1 hypertension. A blood pressure of 140/90 or higher is stage 2 hypertension, and readings of 180/120 or greater constitute a hypertensive crisis requiring urgent medical care.

This shift underscores a critical message: waiting for blood pressure to reach very high levels before acting is no longer acceptable. Early lifestyle changes, and medication when appropriate, can prevent irreversible damage to the heart, brain, and kidneys.

At the core of hypertension prevention and control is a heart-healthy lifestyle. Regular physical activity, a diet rich in fruits, vegetables, and whole grains, and limiting sodium and unhealthy fats are foundational steps. Maintaining a healthy weight is particularly important; for individuals who are overweight or obese, even a 5% reduction in body weight can significantly lower blood pressure. Avoiding smoking, limiting alcohol intake, getting seven to nine hours of quality sleep, and managing stress also play an important role.

For many patients, dietary changes are especially powerful. The Philippine Society of Hypertension recommends the Dietary Approaches to Stop Hypertension (DASH) meal plan for individuals without kidney insufficiency. The DASH diet emphasizes fruits, vegetables, low-fat dairy, fish, whole grains, fiber, potassium, and other essential minerals, while limiting red and processed meat, sugar-sweetened foods and beverages, saturated fat, cholesterol, and sodium.

Lifestyle measures are the first-line treatment for hypertension and work hand in hand with medications. Most people with hypertension will require maintenance medicines for life to keep their blood pressure under control and prevent complications. It is essential that patients take their medications exactly as prescribed and never stop treatment without consulting their doctor, even when they feel well.

Home blood pressure monitoring is another important tool. The American Heart Association recommends that all individuals diagnosed with hypertension use an automatic, cuff-style, upper-arm blood pressure monitor at home. Accurate home readings help doctors determine whether treatments are working and guide medication adjustments. Patients should ensure the correct cuff size, avoid smoking, caffeine, or exercise 30 minutes before measurement, rest quietly for at least five minutes, and take readings at the same time each day. Recording and sharing these readings during medical appointments strengthens shared decision-making between patients and healthcare providers.

Hypertension remains a major public health challenge in the Philippines but it is also one of the most preventable. The research-based pharmaceutical industry recognizes its central role in cardiovascular disease and is committed to expanding access to diagnostics, effective treatments, and patient education. Through the Pharmaceutical and Healthcare Association of the Philippines, member companies are supporting awareness campaigns, strengthening hypertension management, and working with stakeholders to reduce the country’s cardiovascular disease burden.

Preventing and treating hypertension early saves lives. It is an investment in healthier families, a more productive workforce, and a stronger healthcare system, one blood pressure reading at a time.