Cardiovascular disease (CVD) remains the leading cause of death worldwide, including in the Philippines. It accounted for 72 percent of deaths in the country in 2021, according to the Philippine Statistics Authority (PSA).

Health experts warned that CVDs can trigger heart failure, and the worst outcome may result in advanced heart failure, with transplants as the ultimate treatment.

Around 64 million individuals globally are diagnosed with heart failure, according to the Philippine Heart Association (PHA).

During the 31 March edition of PHA's Usapang Puso sa Puso, Dr. Liberty Yaneza, heart failure section head of the Philippine Heart Center (PHC), noted that heart, hypertensive, or diabetic patients are more at risk of developing heart failure. In the long run, this can lead to advanced heart failure, a condition where conventional treatments no longer work.

Yaneza also urged the public to keep diseases of the heart, blood vessels, and stroke at bay; adhere to healthier lifestyle habits; and seek regular professional consultation.

Meanwhile, Dr. Jun Aventura Jr., PHA director and PHC executive director, highlighted the growing concern over heart failure in the country.

Aventura said that a heart transplant is the ultimate treatment for advanced heart failure, which is now available at the PHC, but it costs a significant sum.

While tertiary hospitals in the country perform liver and kidney transplants, as well as cataract or lens replacement surgery, the PHC remains the only hospital with a Heart Transplant Program, which was relaunched in 2024.

Currently, it is still in the process of accepting referrals while the PHC Heart Transplant Program Team undergoes a series of training sessions abroad.

"Let's not wait until heart failure reaches a serious level before taking action. Early detection and actually doing something about it are two different things," Aventura warned.

Yaneza likewise stressed that heart failure "is a serious health issue" in the country.

Citing recent studies, Yaneza said heart failure showed a prevalence rate of approximately 1.6 percent, meaning 16 out of every 1,000 adult Filipinos are affected.

"This is concerning since heart failure is a common cause of hospitalization, leading to high healthcare costs and a lower quality of life for patients," she added.

What to watch out for

Symptoms of heart failure include shortness of breath, making it difficult for patients to lie down comfortably.

Some patients wake up in the middle of the night due to fluid buildup in the lungs, while others experience swelling in the lower extremities, swollen neck veins, fatigue, or loss of appetite.

"Heart failure is a 'great mimicker' because symptoms like breathing difficulties are often mistaken for lung problems or other conditions," Yaneza said.

The PHC official emphasized that it is best to consult a doctor for an accurate diagnosis.

Yaneza also described heart failure as palyado na puso, where the heart struggles to supply blood and nutrients to the body, affecting other organs like the brain and kidneys.

She also explained the four stages of heart failure. In Stage A, there is no heart failure yet, but the risk is high due to conditions like diabetes, high blood pressure, or obesity. In Stage B, symptoms have not appeared yet, but the heart may already show abnormalities like weakened or thickened heart muscles. In Stage C, symptoms start to appear. Stage D is advanced heart failure, where hospitalization is frequent and medication becomes less effective.

“Some people think they just need more exercise, that they’re gaining weight, or that it is just heartburn. But it is important to see a doctor as early as possible,” Yaneza cautioned.

Yaneza advised the public to monitor key health indicators, including body mass index, blood pressure, cholesterol, and blood sugar levels.

Hypertensive individuals should take their maintenance medication regularly, especially those with risk factors. She also recommended exercising, reducing salt intake to 1,500 milligrams (half a teaspoon) per day, minimizing sugar and carbohydrates, cutting down on fats and cholesterol, and avoiding alcohol and smoking.

PHC Heart Transplant Program needs gov’t funding

As PHC is the only institution in the country that is about to offer heart transplants, Yaneza said past PHC directors had already been planning its full implementation before the Covid-19 pandemic.

“Our heart transplant team is fully trained, including overseas training in Taiwan. We are ready and currently preparing the patient list,” she said.

However, Yaneza stressed that for the program to be sustainable, all stakeholders—including the government—must be involved.

“It needs full support from the Department of Health and local government units because heart transplant is expensive. Patients need to take lifelong immunosuppressant medication to prevent rejection of the new heart,” she explained.

Aventura pointed out that government support is possible, citing that the country already performs hundreds of kidney transplants annually.

“We also have the kidney transplant. We do hundreds of kidney transplants per year, and it is not far away from the cost of having a cardiac transplant, so basically that could be a sort of like comparison because if the government was able to give and support [the] kidney institute, they could also support our heart institute,” he said.