A 72-year-old woman attends her GP for a review of her recent investigations. Her blood pressure at her last visit was 164/92 mmHg and so ambulatory blood pressure monitoring was organised. This showed an average daytime blood pressure of 158/96 mmHg. PMH. Osteoarthritis. DH. Paracetamol 1 g PO 6-hrly as required. SH. Minimal alcohol intake, non-smoker. On examination the heart rate is HR 72/min and rhythm regular, BP 154/94 mmHg. No ankle oedema. Investigations show normal serum electrolytes, renal function and ECG. Routine urinalysis is negative

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Population growth is steadily slowing down. The 2020 Census of Population and Housing (CPH) recorded about 109 million Filipinos, almost nine (9) million more compared to the population recorded in 2015. The population increased at a rate of 1.6 from 2015- 2020 which is slower than the 1.7 annual growth rate between 2010–2015. Generally, as shown in Figure 1, the population growth rate has slowed down since the 1970’s. While this is considered a positive gain, the Philippines, however, is ranked 13th as the most populous around the world (UNDESA). It is also the second most populous country among members of the Association of Southeast Asian Nations (ASEAN). Moreover, it is observed that socioeconomic and regional disparities exist even if the population growth has dwindled. Figure 2. Trends in the total fertility rate, 1973 to 2022 Source: PSA, Various NDHS Filipino women have fewer children compared to past generations. The 2022 National Demographic and Health Survey showed a rapid decline in fertility, reaching replacement level total fertility rate (TFR) of 1.9 from 2.7 in 2017. The TFR has been on a decline since the 1980s, albeit, at a slower pace than what was experienced by most neighboring countries in East and Southeast Asia (Costello and Casterline, n.d.). These trends nevertheless have resulted in a change in age structure of the population. The proportion of children under five years old has declined, although there will still be many school- aged children in the next 15 years. The working age population (15-64) is expected to increase along with the older population 65 and over. In 2010, the proportion of 65 years old and over reached 4.3%. This increased to 5.4% in 2020. The increase in the number of the working age population is the outcome of a long period of population growth. A demographic bonus or dividend is expected to occur once population growth starts to slow down. The maximum utilization of these human resources provides a potential for higher productivity and contributes to economic growth.

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