An Overview of the PRESYON 4 Trial and Its Impact on Practice

Cardiovascular diseases have overtaken infectious diseases as the most common causes of morbidity and mortality in the Philippines. Among Filipinos, hypertension is the most common risk factor associated with cardiovascular diseases. The Philippine Heart Association–Council on Hypertension Report on Survey of Hypertension (PRESYON study series) were initiated to assess the problems of increased cardiovascular disease prevalence. The PRESYON studies found an increase in the prevalence of hypertension, from 22% in the 1990s to 37% in 2021. There was also an increase in obesity in the hypertensive population, and the prevalence of smokers was persistently high. However, the incidence of diabetes, stroke and MI decreased slightly. The 2021 survey (PRESYON 4) found a higher BMI and central obesity rate among hypertensive individuals. Angiotensin receptor blockers are the most commonly used drugs for the treatment of hypertension. Despite high rates of treatment (68%) and compliance (86%), the rate of blood pressure control remains low (37%). Most patients are on monotherapy. There was a high level of unawareness of high blood pressure. Hypertension remains a problem in the Philippines due to its increasing prevalence, high rates of unawareness, low rates of blood pressure control and a poor risk profile. Physicians should be more aggressive in achieving blood pressure control, especially through the use of drug combinations, and controlling risk factors through patient education, promoting a healthy lifestyle and smoking cessation.