IN a nation known for its resilience and vibrant culture, heart disease continues to cast a dark shadow over millions of Filipino families.
Despite medical advancements and government campaigns, cardiovascular disease remains the leading cause of death in the Philippines, claiming over 120,000 lives annually according to the Department of Health (DOH).
This silent killer not only threatens lives but also places a heavy burden on families and the nation’s healthcare system.
Here in Cagayan de Oro, it has been the leading silent killer with a five-year (2017-2021) average of 1,040 (Myocardial Infarction).
This report aims to uncover the real cost of heart disease, examining gaps in healthcare access, socio-economic barriers, and lifestyle factors contributing to this growing crisis.
A lifeline out of reach
For residents of urban centers like Cagayan de Oro, access to hospitals equipped with modern cardiac care units is relatively easier.
However, for those living in rural and remote areas, the reality is starkly different.
In Barangay Dansolihon, an upland village at least an hour away from Cagayan de Oro downtown, 52-year-old farmer Tony Pedimonte suffered a heart attack in late 2023.
His wife, Maria, recalls the harrowing experience of getting him to the nearest hospital.
“We had to hire a habal-habal (motorcycle taxi) to take us down the mountain,” Maria said. “By the time we reached the hospital, it was too late.”
The City Health Office here noted that many heart patients arrive at the hospital in critical condition because they lack access to early diagnosis and treatment.
“We promised the World Health Organization that the Philippines would be one of the healthy people in Southeast Asia by 2022. We failed to keep that promise,” Dr. Rachel Dilla, city health officer, said.
She said the next pledge will culminate in 2030 when the country aims to be one of the healthiest in Asia.
Dilla said the City Health Office is implementing various programs to achieve that pledge.
According to the Philippine Statistics Authority (PSA), Northern Mindanao has one cardiologist for every 25,000 people, far below the World Health Organization’s (WHO) recommended ratio of one per 10,000.
In rural barangays, residents rely on general practitioners who often lack the specialized knowledge to manage heart conditions.
Barangay health worker Lucia Ramos shared her frustrations.
“We don’t have the equipment to check blood pressure regularly,” Ramos said. “People come to us when they’re already very sick.”
The City Health Office, here, currently has 25 doctors to serve the roughly 750,000 residents of the city. Dilla said the ratio should be a doctor for every 20,000 residents.
“We are still trying to hire 38 additional doctors to serve the 56 health centers in the city,” Dilla said. The city has 80 barangays with 40 urban barangays and 40 rural barangays.
She added that currently, they hold field consultations once every week through the city government’s “Barangay Day.”
The cost of staying alive
Heart disease does not just take lives; it also drains financial resources. In many cases, the high cost of medical care pushes families into poverty.
Rafael Moreno, a 52-year-old jeepney driver in Cagayan de Oro, has been battling coronary artery disease for five years. His family has spent more than P300,000 on medications, hospital visits, and a life-saving angioplasty procedure.
“I had to sell our farmland to pay for my operation,” Moreno said. “Now, we’re struggling to pay for my maintenance medicines.”
A study by the Philippine Heart Association (PHA) found that managing heart disease can cost an individual P3,000 to P5,000 monthly for maintenance medications alone.
This figure excludes diagnostic tests, consultations, and emergency hospitalizations, which can amount to tens of thousands of pesos.
Many Filipinos rely on PhilHealth, the government’s health insurance program, to help cover medical costs. However, coverage is often limited.
Although maintenance medicines for heart ailments are free at the City Health Office, the availability of stocks and other instances could be a problem here.
“Maintenance medicines have always been given free at our health centers. However, some could afford to buy their own and still want to get their medicines here for free. We cannot deny them the medicines because they say they are taxpayers and should also get the free medicines,” Dilla said.
The financial toll of heart disease extends beyond immediate medical expenses. When a family member becomes ill, other family members often have to stop working to provide care.
This loss of income exacerbates the economic strain.
In rural Barangay Dansolihon, Estrella Dimaporo, a widow, shared how her husband’s heart attack changed their lives forever.
“We had no savings,” Dimaporo said. “After his death, I had to borrow money to pay for his funeral and medical bills.”
A cultural shift needed
The rise in heart disease cases can be attributed to several lifestyle factors, including poor diet, lack of exercise, and smoking. Urbanization has brought convenience, but it has also introduced unhealthy habits.
The DOH’s Philippine Package of Essential Non-communicable Diseases (PhilPEN), is a program that screens adults for risk factors of non-communicable diseases (NCDs). It is implemented in partnership with local government units.
At the center of these NCDs is Atherosclerotic Cardiovascular Disease (ASCVD). Dilla explained that this disease refers to conditions caused by the buildup of atherosclerotic plaque in the arterial walls, which can lead to the narrowing and hardening of arteries, reducing blood flow.
This disease is a major cause of cardiovascular events and includes conditions such as:
Coronary artery disease (CAD): Includes heart attacks (myocardial infarction) and angina (chest pain).
Cerebrovascular disease: Includes strokes and transient ischemic attacks (TIAs).
Peripheral artery disease (PAD): Affects arteries in the limbs, often causing leg pain during walking (claudication).
In cardiology care, ASCVD is important because it guides risk assessment, prevention strategies, and treatment decisions, especially related to cholesterol management, blood pressure control, lifestyle changes, and the use of medications like statins.
The program aims to address “lifestyle diseases” such as heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, diabetes, and hypertension.
Dilla said the program is open to residents aged 20 years old and older.
“We promote healthy places in the city. Like, the boulevard where you can briskly walk or jog without fear of being run over by vehicles,” she said.
With PhilPEN, Dilla said they monitor the residents’ body mass index, blood pressure, and other risk factors the residents may be doing.
“We have ‘no judgment approach’ here. We don’t sermon to the people. We just have ‘health teaching.’ We teach people how to prepare meals that are both healthy and affordable. We’ve seen a reduction in hypertension cases among our participants,” she said.
Despite these efforts, unhealthy eating habits remain prevalent. Fast food chains have become a staple in many Filipinos’ diets, contributing to rising obesity rates.
“People need to understand that what they eat affects their heart. Cholesterol is a key risk factor,” Dilla said.
However, it can be managed effectively through lifestyle changes and medical intervention.
Stories of struggle and hope
This investigation took this reporter to various upland communities in Cagayan de Oro, where stories of struggle and hope emerged.
In Barangay Tinagpoloan, 68-year-old widow Estrella Dimaporo recounted how she lost her husband to a heart attack.
“We didn’t know he had a heart problem,” Dimaporo said. “If only we had regular check-ups, maybe he’d still be here.”
In contrast, Barangay Lumbia’s Barangay Health Station is making a difference.
Resident Maricel Yañez said their grassroots efforts have helped residents adopt healthier lifestyles.
“We’re seeing more people exercise and eat healthier,” Yañez said. “It shows that change is possible.”
Policy recommendations
Experts agree that addressing heart disease requires a multi-faceted approach. Key recommendations include:
Increase the Number of Cardiologists: Especially in rural areas, to ensure timely diagnosis and treatment.
Expand PhilHealth Coverage: Include more comprehensive cardiac care packages, covering both preventive and maintenance care.
Strengthen Grassroots Health Programs: Encourage local government units to implement heart health initiatives.
Promote Lifestyle Changes: Through sustained education campaigns and community-based programs.
“Heart disease is preventable,” Dilla said. “With the right policies and community efforts, we can reduce the burden of this silent killer.”
A call to action
The stories from Cagayan de Oro and beyond underscore the urgent need for action at both national and local levels. Heart disease is not just a health issue; it is a social and economic concern that requires a coordinated response from the government, private sector, and civil society.
Dilla said the time to take action is now.
“Now is the time to act because the next heart attack or stroke could be worse—or even fatal. Don’t wait for a crisis to strike. Simple steps today can protect your heart tomorrow,” she said.
Mayor Rolando Uy of Cagayan de Oro summed it up best: “A healthy community is a strong community. We need to invest in our people’s health.”
As the country continues to grapple with the challenges of heart disease, it is clear that more needs to be done to unmask the real cost of this silent killer and pave the way for a healthier future for all Filipinos.
(This article is part of the Unblock Your Heart Health Reporting initiative, supported by the Philippine Press Institute and Novartis, to improve health literacy on cardiovascular diseases. Know your numbers, understand your risks, and consult your doctor—so no Filipino heart is lost too soon. Take control of your heart health today. Visit unblockedmovement.ph for more information)
