'Heart failure is deadly'

MANILA, Philippines - Local experts warned against the deadly threat posed by heart failure and urged the general public to be vigilant in preventing the common condition and recognizing its symptoms. 

“Half of patients with heart failure die in five years. Heart failure is more fatal than colon cancer,” said Dr. Romeo Divinagracia, professor and cardiology consultant at the University of the East Ramon Magsaysay Memorial Medical Center.

“Heart failure is a serious condition that should be promptly recognized to enable immediate and appropriate treatment,” said Dr. Eugene Reyes, vice chairman of the Department of Medicine of Manila Doctors Hospital.

Divinagracia and Reyes were the keynote speakers during a medical symposium entitled “Another Look at the Use of Metoprolol for the Failing Heart” organized by research-based biopharmaceutical company AstraZeneca at the Edsa Shangri-La Hotel last May 26.

According to Divinagracia, heart failure is a condition in which the heart muscles are weakened or damaged, making them unable to fill with and/or pump blood as well as it should. Common symptoms of heart failure are shortness of breath, fatigue and swelling in the extremities and abdomen, he said. 

“The most common causes of heart failure are high blood pressure, diabetes and coronary artery disease or the narrowing and clogging of the heart’s arteries due to plaque buildup. Heart failure is more common in people aged 65 and older and those who are overweight, which is also a risk factor for type 2 diabetes,” said Reyes.

Divinagracia, who founded the Heart Failure Society of the Philippines in 1996, referred to the “paradox of heart failure.” In the 1960s, he explained, there were relatively few heart failure cases in the world because patients with hypertension or those who suffered a heart attack usually did not survive long.

But with the advent of modern medical technology and breakthrough drugs, more and more hypertensive patients and heart attack survivors are now able to live longer. “These are the patients who are likely to develop heart failure,” Divinagracia said.

Aside from healthy lifestyle changes, several classes of anti-hypertension medicine are used to manage heart failure. One of these is the beta blocker metoprolol.

“Beta blockers lower blood pressure and slow the heart rate, thereby decreasing the heart’s workload and helping strengthen its pumping ability. These beneficial effects slow disease progression and protect patients against deterioration,” said Reyes. 

He said the ideal treatment approach for heart failure is to go “slow and low,” something not possible with the conventional beta blocker tablet formulation.

“A once-daily controlled-release beta blocker is better than the ordinary beta blocker because it ensures a continuous, even concentration of the drug in the blood. This enhances the drug’s efficacy while minimizing the risk of side effects which, in turn, promotes patient compliance,” he said.

A product of AstraZeneca, controlled-release metoprolol is a divisible tablet consisting of multiple pellets containing the drug designed to deliver at a slow rate that provides even drug concentrations in the blood and its effects over 24 hours in contrast to conventional metoprolol tablet formulations.

Controlled-release metoprolol is currently licensed in the Philippines for symptomatic mild to severe chronic heart failure as an adjunct to other heart failure therapy. It is a prescription medication and should only be used upon the advice of a doctor.