Since the year 1972, several organizations have assigned “words of the year” or WOTY to define what is considered the most important word of the year, basically reflecting the theme or expression that best describes the year that was. It can be a cultural phenomenon, a controversy, an influential concept, or a popular thought. This WOTY is voted upon by linguists and lexicographers and the bodies that designate these include the American Dialect Society, Cambridge University for the Cambridge Dictionary, Collins English Dictionary, Dictionary.com, Macquarie Dictionary, Merriam Webster, and Oxford University Press for the Oxford Dictionary, among others.

Hypertension is the most common risk factor for cardiovascular disease in the Philippines. Despite the availability of antihypertensive medications that are effective, safe, and tolerated by Filipino patients, the numbers of uncontrolled hypertensives are still increasing. Several factors play in the poor control of blood pressure, particularly resistant hypertension and hyperactive sympathetic nervous system.

For centuries, hypertension (HTN) has been a major cause of cardiovascular morbidity and mortality. Even now in 2024, despite all the advances in its understanding, adequate diagnosis and treatment of HTN globally is still sorely lacking. In a 2022 publication it is estimated that as much as 54% of hypertensive patients worldwide are undiagnosed. 42% of the hypertensive patients are both diagnosed and treated, yet only 21% of all hypertensive patients have blood pressure (BP) under control(1).

Obviously, on a global scale there are way too many factors and variables that need to be addressed. Yet as practicing clinical physicians we are left to do what we can for the patients we encounter. Assuming there is a program in place to ensure compliance and follow-up, it is estimated that 82% of patients can achieve target BP(2). By simple calculation however, that also means nearly 20% of compliant patients will still not achieve target BP levels despite adequate medical treatment. And amongst those who do, around 20% would be on 3 or 4 anti hypertensive agents(3). This then begs the question… what else can we do for these difficult-to control patients?

Acute coronary syndrome (ACS) is a leading cause of admission and mortality in a tertiary care hospital in the Philippines. The significant burden of the disease necessitates that evidence-based care set by international and local guidelines be met to improve service delivery and quality of care (QOC). Institution-specific QOC studies showed gaps between guideline recommendations and compliance. Development and utilization of a clinical pathway are among the identified strategies to improve compliance. It is also crucial for implementation of standard-of-care set specific to a hospital setting based on its needs and resources.

Let we, who are supposed experts of the heart and know that there’s a tiny node at the roof of the right atrium that fires impulses automatically to the demand of the body with nary our care or intent, pause for a moment to appreciate what it took for our forefathers to put us in this position of knowledge; and, by the same awareness, be humbled to realize that there’s a lot more beyond what we know and understand.