Trends in prevalence of diet-related cvd risk factors

NNS reports increasing prevalence of nutrition-related risk factors for CVD among Philippine adults aged 20 years and over. These include overweight and obesity, as discussed earlier, as well as hypertension, diabetes and some indicators of dyslipidaemia.

Hypertension

In NNS 2003, 22.5 percent of Philippine adults were diagnosed as hypertensive, based on blood pressure (BP) (systolic BP > 140 mm Hg, or diastolic BP > 90 mm Hg) - a significant increase from the 21 percent of 1998. The figures among middle-aged and elderly adults were even higher, ranging from 26.4 percent among those aged 40 to 49 years, to 40.2 percent among those aged 50 to 59 years, 45.8 percent in the 60 to 69 years age group, and 56 percent among people aged 70 years and over.

TABLE 20
Trends in the prevalence of hypertension among adults aged 20 years and over, 1998 and 2003

Sample sizes: 1998, 9 299; 2003 - 20 to 39 years, 1402; 40 to 59 years, 1 021; ³ 60 years, 2 330.
Reference: systolic BP > 140 mm Hg; diastolic BP > 90 mm Hg.
Source: NNS, 1998; 2003.

Dyslipidaemia

The prevalence of hypercholesterolaemia among Philippine adults in 2003 was 8.5 percent, which is more than twice the rate of 4 percent in 1998. There was a significant increase in the prevalence of hypercholesterolaemia over this period, particularly among middle-aged and older adults, among whom the condition remained significantly more prevalent (at 10 to 20 percent and 15 percent, respectively) than it did in younger adults.

The prevalence of elevated LDL-cholesterol among Philippine adults in 2003 was 3.7 percent, which is significantly higher than (nearly double) the 1998 rate of 2 percent. Over the five-year period, the prevalence of elevated LDL-cholesterol increased significantly among middle-aged and elderly adults.

The increasing trend in hypercholesterolaemia and elevated LDL-cholesterol may be associated with increased consumption of animal-based foods, particularly meats and possibly fats and oils, as well as the decreasing fruit and vegetable consumption as discussed earlier. There is no evidence to suggest increases in the prevalence of low HDL-cholesterol (< 35 mg/dl), which was 3.5 percent in 2003. However, using the cut-off of < 40 mg/dl, 54.2 percent of Philippine adults in NNS 2003 had predisposition to low HDL. Low HDL is associated with low consumption of fruits and vegetables, low physical activity and smoking. In NNS 2003, 62 percent of Philippine adults reported being physically inactive, 35 percent were current smokers, and 10 percent were former smokers.

TABLE 21
Trends in dyslipidaemia among adults aged 20 years and over, 1998 and 2003

Sample sizes: 1998, 9 299; 2003 - 20 to 39 years, 1 402; 40 to 59 years, 1 021; ³ 60 years, 2 330.
¹ Elevated total cholesterol = ³ 240 mg/dl.
² Elevated LDL-cholesterol = > 190 mg/dl.
³ Low HDL-cholesterol = < 35 mg/dl.
⁴ Elevated triglycerides = ³ 400 mg/dl.
Source: NNS, 1998; 2003.

There is also no evidence of an increasing prevalence of elevated triglycerides that could be associated with the increasing consumption of fats and oils (most of which is coconut oil) in Philippine households. Overall, fewer than 1 percent (0.7 percent) of Philippine adults had elevated triglycerides, which was slightly lower than the 1998 rate (0.8 percent).

In a study on hypertension among Philippine adults, which used data from NNS 1998, Duante et al. (2001) identified triglyceride level as one of the significant risk factors for hypertension, but there was no attendant increase in triglycerides with the increased prevalence of hypertension between 1998 and 2003. However, disaggregating the data by age group reveals increasing prevalence of elevated triglycerides among the elderly, rising from only 0.4 percent in 1998 to 0.8 percent among 60- to 69-year-olds and 1.1 percent among those aged 70 years and over in 2003. These groups also had the highest prevalence of hypertension.

Diabetes

The Philippine data show no evidence of a trend towards increasing prevalence of diabetes mellitus; this is surprising given that obesity increased significantly. The proportion of Philippine adults with diabetes mellitus was 3.9 percent in 1998, and 3.4 percent in 2003. However, the proportion of Philippine adults with impaired fasting blood glucose (FBG) - a prediabetic condition that increases the risk of diabetes - rose from 2.5 percent in 1998 to 3.2 percent in 2003 (FBS = 100 - 125 mg/dl).

TABLE 22
Trends in the prevalence of impaired FBG and diabetes mellitus among adults aged 20 years and over, 1998 and 2003

Sample sizes: 1998, 9 299; 2003 - 20 to 39 years, 1 402; 40 to 59 years, 1 021; ³ 60 years, 2 330.
Diabetes mellitus = FBS ³ 126 mg/dl.
¹ FBS = 110 - 125 mg/dl.
² FBS = 100 - 125 mg/dl.
Source: NNS, 1998; 2003.