Conquering the rising cardiovascular disease epidemic

THE inaugural Monash Cardiovascular Summit held on May 9 and 10 got hearts pumping and minds running overtime with an enthralling two-day summit about the No. 1 cause of mortality in Malaysia – cardiovascular disease (CVD).

The alarming prevalence of CVD-related illnesses and fatalities not only affects patients and their families but also inflicts an unsustainable economic burden on the nation.

Treatment costs have reached a staggering RM3.9 bil annually, accounting for more than 40% of the total direct healthcare cost of non-communicable diseases (NCDs). The impact extends beyond medical expenses, causing an estimated annual productivity loss of approximately RM4 bil.

Even with efforts to raise awareness and reduce the relative risk of mortality, these alarming facts still prevail:

  • CVD kills one person every 30 minutes
  • As of 2019, four-in-10 of all adults in Malaysia had hypercholesterolemia, three-in-10 had hypertension and one-in-5 had diabetes mellitus. Diagnosis for hypercholesterolemia remains the lowest.
  • The NCVD-ACS registry reports 25% of patients are below 50 years old and Malaysia is moving towards an ageing population. These two spectra of age factors further compounds the increasing risk of CVD.

Experts and participants at the summit agreed that the Malaysian Government and healthcare providers need to take this matter seriously and look into ways to conquer the rising disease.

Overcoming public challenges

Strengthening existing interventions and implementing new ones should be the first step in tackling the CVD epidemic. However, despite concerted efforts to raise public awareness about CVD, there remains a significant hurdle in influencing public perception and inspiring action.

The resistance to accept and act on the necessary measures persists, hindering progress in combating this silent killer. Most patients, for example, do not know they have a cholesterol problem because this doesn’t come with obvious symptoms and can only be known through health screening.

In the summit’s forum titled “Heart Matters: The Rising Burden of Cardiovascular Disease in Malaysia”, senior consultant cardiologist at the University of Malaya Medical Centre Datuk Dr Wan Azman Wan Ahmad shared his belief that there is a need for a shift in public attitude towards the importance of controlling cholesterol to prevent heart-related diseases.

He highlighted that many individuals stop their cholesterol medication after 15 months of treatment due to the absence of symptoms and the misconception that their cholesterol levels are already under control. However, they fail to realise that their favourable cholesterol levels are a result of the medication.

Dr Koh Kar Chai, an advisory council member for the Health White Paper, highlighted the challenges in the private sector. Patients often have their perceptions of health, neglecting follow-ups after primary care visits. Early detection is crucial for controlling risk factors.

The Sarawak Minister of Public Health, Housing & Local Government Datuk Seri Prof Dr Sim Kui Hian, made an intriguing observation. In his late father’s generation, risk factors such as hypercholesterolemia, hypertension, and diabetes were seen as abnormal. However, in present times, not having any of these risk factors is now considered abnormal.

Many patients choose not to continue their medication due to concerns about potential side effects, particularly with medications like statins. Additionally, the lack of noticeable symptoms of high cholesterol leads them to believe their cholesterol levels are already under control.

However, this decision results in poorly controlled cholesterol levels, increasing the risk of CVD. Hence, exploring alternative medications becomes necessary.

That said, it is crucial to motivate patients to actively engage in health screenings and seek guidance from healthcare professionals. Treating cholesterol with a holistic approach is of utmost importance, including monitoring, lifestyle modifications and medication.

In addition, it is also the time to explore more effective methods of cholesterol control such as combination therapy involving a combination of medicine and injections. – July 25, 2023


Main pic credit: Add More To Life websiste

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