Even as the Philippines directed its collective attention toward the pandemic, a quieter epidemic continued its toll: stroke, the country's third leading cause of death, claimed nearly 100,000 Filipino lives in 2020 alone. In September 2021, Menarini Asia-Pac convened medical experts and a stroke survivor to illuminate how atrial fibrillation silently manufactures the blood clots that travel to the brain—and how that journey, so often fatal, is preventable. The campaign is a reminder that the oldest threats to human life do not pause for newer ones, and that prevention is less a medical miracl
Blood clots pose hidden threat as NCDs deprioritized during pandemic
Stroke caused 99,700 deaths in Philippines in 2020, with atrial fibrillation-related strokes affecting vulnerable populations and potentially causing permanent brain damage or death.
A clot that forms in the heart can travel anywhere—to the brain, the lungs, the legs.
Mark
Why does atrial fibrillation create such a high risk for stroke specifically?
Mimi
Because when the heart beats irregularly, blood doesn't flow smoothly through the chambers. It pools and stagnates, especially in the upper chambers. When blood sits still, it clots. And a clot that forms in the heart can travel anywhere—to the brain, the lungs, the legs. The brain is particularly vulnerable because it needs constant oxygen flow. A clot there is catastrophic.
Mark
The source mentions that stroke is the third leading cause of death in the Philippines. Why is that significant?
Mimi
It means we're not talking about a rare condition. Nearly 100,000 Filipinos died from stroke in 2020 alone. That's not a footnote in the health statistics. That's a crisis that's been happening quietly while everyone was focused on COVID. And most of those deaths were preventable.
Mark
You keep saying preventable. But the article emphasizes medication adherence. That sounds like it's placing the burden on the patient.
Mimi
It does, and that's the tension. Yes, the patient has to take their medication. But the system has to make that possible. If someone can't afford their anticoagulant, or can't get to a pharmacy, or doesn't understand why they need to take a pill every single day when they feel fine—that's not a failure of willpower. That's a failure of the system to support them.
Mark
What does a stroke survivor like Ramonito Saturno represent in this story?
Mimi
He's the proof that this isn't abstract. He lived through what happens when a clot reaches the brain. He knows what he lost. And he's there at a forum in 2021, during a pandemic, trying to tell people: this still matters. We haven't stopped dying from this.
Mark
If atrial fibrillation is common in Filipinos over 70, why isn't there more screening?
Mimi
Because NCDs have been deprioritized. The resources, the attention, the public health campaigns—they've all gone to COVID. An 75-year-old with an irregular heartbeat isn't an emergency until they have a stroke. By then, it's too late.
O Pulso
- While COVID-19 dominated public health resources, non-communicable diseases responsible for 71% of global deaths were quietly pushed to the margins of care and attention.
- Atrial fibrillation—an irregular heartbeat common among Filipinos over 70—causes blood to pool and clot, making stroke three to five times more likely for those affected.
- Stroke struck with devastating force in 2020, killing 99,700 Filipinos, with clot-caused ischemic strokes accounting for 87% of all cases and capable of causing permanent brain damage within minutes.
- Anticoagulant therapy can prevent these strokes, but medication non-adherence remains the critical weak point between a working treatment and a life-altering event.
- Doctors, pharmacists, and patients must form a coordinated front—addressing affordability, access, and daily habit—to make prevention a lived reality rather than a clinical recommendation.
Even as the Philippines directed its collective attention toward the pandemic, a quieter epidemic continued its toll: stroke, the country's third leading cause of death, claimed nearly 100,000 Filipino lives in 2020 alone. In September 2021, Menarini Asia-Pac convened medical experts and a stroke survivor to illuminate how atrial fibrillation silently manufactures the blood clots that travel to the brain—and how that journey, so often fatal, is preventable. The campaign is a reminder that the oldest threats to human life do not pause for newer ones, and that prevention is less a medical miracle than a daily, unglamorous act of commitment.
For nearly two years, COVID-19 consumed the Philippines' headlines and health system, but the diseases already present before the pandemic never stopped. Heart disease, stroke, diabetes, and cancer—non-communicable diseases that account for 71 percent of deaths worldwide—were quietly deprioritized as emergency consumed everything else.
In September 2021, pharmaceutical company Menarini Asia-Pac gathered cardiologists, stroke specialists, and a stroke survivor in a virtual forum to confront one of those neglected threats: thrombosis, or blood clots. The forum explained how clotting, normally a protective response to injury, becomes dangerous in people with atrial fibrillation—an irregular heartbeat that causes blood to pool inside the heart's upper chambers. When those clots break free and reach the brain, the result is stroke.
The scale of the problem in the Philippines is difficult to absorb. Stroke is the country's third leading cause of death, and in 2020 it killed 99,700 Filipinos—a 2.3 percent rise from the year before. Those with atrial fibrillation face three to five times the stroke risk of others, and the condition is especially prevalent among Filipinos over 70, who are already managing multiple vulnerabilities.
The damage a stroke inflicts can be permanent. Brain cells begin dying within minutes of a blocked blood supply, and while some patients experience warning episodes beforehand, many receive no signal at all. Yet strokes tied to atrial fibrillation are preventable with anticoagulant medications—if patients take them consistently.
That consistency is the hardest part. Medication adherence is unglamorous, repetitive work, and when it breaks down, so does prevention. The forum's message was clear: doctors must understand whether patients can afford and access their prescriptions, pharmacists must guide patients through assistance programs and alternatives, and both must help build the daily routines that turn a prescription into a habit. A stroke survivor's testimony made the stakes concrete—what separates a full life from one interrupted by paralysis or death can be as simple, and as difficult, as taking a pill at the same time every day.
The pandemic has a way of narrowing focus. For nearly two years, COVID-19 consumed the headlines, the hospital beds, the public health budget, the collective anxiety. But while the world watched the virus, something older and quieter kept killing Filipinos: the diseases that were already here. Heart disease. Stroke. Diabetes. Cancer. Chronic lung disease. These non-communicable diseases, or NCDs, account for 71 percent of all deaths worldwide, yet during the pandemic they have been quietly deprioritized, pushed to the margins of a health system suddenly consumed by emergency.
In September 2021, Menarini Asia-Pac convened a virtual forum to talk about one particular threat that sits at the intersection of these neglected diseases: blood clots, or thrombosis. The company brought together Dr. Marcellus Ramirez of the Philippine Heart Rhythm Society, Dr. Johnny Lokin of the Stroke Society of the Philippines, and Ramonito Saturno, a stroke survivor, to discuss how clots form, why they matter, and what happens when they travel to the wrong place in the body.
Thrombosis itself is not inherently dangerous. It is a normal protective mechanism—when a vein ruptures, platelets and a protein called fibrin coagulate to form a seal, stopping the bleeding. The clot dissolves as the injury heals. But some people develop clots abnormally, particularly those with atrial fibrillation, an irregular heartbeat caused by uncoordinated pumping of the heart's chambers. When the heart beats irregularly, blood pools and clots form inside the upper chambers. These clots can break loose and travel through the bloodstream, lodging in arteries and blocking blood flow. If a clot reaches the brain, the result is stroke.
The numbers are stark. Stroke is the third leading cause of death in the Philippines, after heart disease and cancer. In 2020 alone, 99,700 Filipinos died from stroke—a 2.3 percent increase from the previous year's 97,500 deaths. For people with atrial fibrillation, the risk is amplified: they are three to five times more likely to suffer a stroke than those without the condition. One-quarter of all strokes in people over 40 are caused by atrial fibrillation. The Department of Health and the Food and Nutrition Research Institute have documented that atrial fibrillation is common among Filipinos over 70, a population already vulnerable to heart, kidney, and lung disease, diabetes, and high blood pressure.
When a clot blocks blood flow to the brain, brain cells begin to die within minutes, starved of oxygen and nutrients. The damage can be catastrophic and permanent. Some patients experience warning signs—brief episodes called transient ischemic attacks, or TIAs, that last from minutes to a full day—but many do not. About 87 percent of all strokes are ischemic, caused by clots rather than bleeding.
The good news, if it can be called that, is that stroke caused by atrial fibrillation is preventable. Anticoagulant medications, commonly called blood thinners, can stop clots from forming. But prevention requires something that many patients struggle with: adherence. Taking medication exactly as prescribed, at the right time, every time, is not glamorous work. It is unglamorous, repetitive, and easy to neglect. Yet medication non-adherence leads to disease progression, death, and higher health care costs. The World Health Organization emphasizes that adherence improves outcomes when patients and physicians collaborate, integrating medical guidance with the patient's own lifestyle, values, and circumstances.
This is where the system must meet the patient. Doctors need to know whether their patients can afford their medications and access a pharmacy. Pharmacists need to explain refill programs, assistance options, and generic alternatives. Both need to help patients develop tracking systems so that taking a daily pill becomes routine rather than an afterthought. A stroke survivor like Ramonito Saturno can testify to what is at stake: the difference between taking a medication as prescribed and not taking it can be the difference between a life lived fully and a life interrupted by paralysis, speech loss, or death. With enough knowledge about what causes thrombotic stroke and a medication program that actually works in a patient's life, prevention is possible. But only if the system—and the patient—stay committed when the headlines have moved on.
Citações Notáveis
Medication adherence, or taking medications correctly as prescribed by the doctor, is an integral aspect of blood clots management that many patients usually take for granted.— Forum discussion on stroke prevention
Adherence helps improve cases of at-risk patients because both the patient and the physician collaborate to improve the patient's status by integrating the physician's medical opinion and the patient's lifestyle, values and preferences for care.— World Health Organization perspective presented at forum
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