Tending to matters of the heart


  • Focus
  • Sunday, 20 Sep 2020

Heart disease is becoming more serious among Malaysians aged 40 and below, based on recent data. More deaths involving heart disease were recorded in this age group, while a bigger percentage need invasive treatment.

IT will be World Heart Day on Sept 29 – a reminder for us to take our heart to heart.

As it is, heart disease is still the number one killer in Malaysia and the world.

For 14 years in a row, ischaemic heart disease (IHD) or heart problems due to narrowed arteries, has been the top cause of death in Malaysia.

It has led to 18,267 deaths, or 15.6% of the total 117,387 deaths in 2018.

More worryingly, it’s becoming more common among those aged between 15 and 40.

For this age group, deaths involving IHD went up from 6.4% in 2017 to 7.2% in 2018, reveals the Health Ministry.

“Although transport accidents remained the principal cause of death for this age group, IHD related deaths have increased, ” the ministry’s disease control division director Dr Norhayati Rusli tells Sunday Star.

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There’s also a bigger percentage of those aged 40 and below who require invasive treatment for IHD, according to the National Heart Institute (IJN).

This age group made up 4.4% of the total number of patients requiring invasive treatment in 2019, but spiked to 5.5% this year.

“The percentage of patients aged 40 and below who need invasive treatment is still small.

“But there is an increasing trend for more young people to require such procedures, ” says IJN cardiovascular sports and fitness director Datuk Seri Dr Jeffrey Jeswant Dillon.

There are two types of invasive treatments: coronary artery bypass graft surgery to improve blood flow to the heart, and percutaneous coronary intervention (PCI) which is a procedure to treat the narrowing of heart arteries.

“The percentage of patients aged 40 and below who need PCI increased from 5.4% in 2019 to 7.4% this year, ” Dr Jeswant points out.

Across ages, male patients outnumber female patients for the treatments, but there has been an increase in females over the past two years, he notes.

“For bypass surgery, female patients rose from 15.8% to 17.1%.

“A bigger percentage of female patients also went through PCI, from 17.5% last year to 19.6% this year, ” he says.

Aside from health implications, heart disease also comes with a negative effect on the economy.

Heart-related disease is one of the main non-communicable diseases (NCDs) that has caused productivity losses in our economy.

On Tuesday, it was reported that NCDs, particularly cardiovascular diseases, diabetes and cancer, cost the Malaysian economy RM8.91bil or about 0.65% of Malaysia’s gross domestic product.

This is based on a report by the Health Ministry and World Health Organisation, which estimated the value of productivity losses due to absenteeism, working while being sick and premature death of workers.

After IHD, the following top causes of death here are pneumonia (11.8%), cerebrovascular diseases (7.8%), transport accidents (3.7%) and chronic lower respiratory diseases (2.6%), data by the Department of Statistics Malaysia showed.

Dr Norhayati says the causes of heart diseases and NCDs are categorised as modifiable and non-modifiable.

“Non-modifiable factors include increasing age, gender, family history of premature cardiovascular disease, ethnicity and genetic diseases.

“Modifiable reasons are poor diet and dietary patterns, smoking, physical inactivity, obesity, hypertension and diabetes, ” she says.

From the available data, Malaysians develop acute coronary syndrome – a condition due to decreased blood flow in the heart arteries – at a younger age compared to neighbouring countries.

“This could be due to a high prevalence of NCD risk factors among the younger age group in Malaysia, as shown by the National Health and Morbidity Survey 2019, ” Dr Norhayati explains.

For example, 11.2% of Malaysians already have raised blood sugar in their early 30s.

“This proportion increases to 24.7% in their late 40s.

“Similarly, 54.6% Malaysians in their early 30s are either overweight or obese, ” she adds.

It’s also a concern that over 90% of those who died in Malaysia due to Covid-19 have at least one risk factor for NCD, such as hypertension, diabetes and smoking.

“Those with heart disease are more likely to have these risk factors, and a higher likelihood of more severe Covid-19 infection and death, ” Dr Norhayati warns.

Amid the pandemic, this year’s World Heart Day campaign theme is to “#UseHeart” to beat cardiovascular disease.

“We don’t know what course the pandemic will take in the future but we do know that taking care of our hearts right now is more important than ever, ” reads the World Heart Federation’s website on the campaign, celebrated on Sept 29 yearly to unite the community in fighting cardiovascular disease.

In the same vein, the Health Ministry is hoping to reduce premature deaths due to cardiovascular disease, cancer, diabetes and chronic respiratory diseases.

It is intensifying efforts to educate Malaysians on leading a healthy lifestyle, advocate for early detection, and providing quality care to people living with NCDs.

“The ministry is guided by the National Strategic Plan for NCDs 2016-2025 in order to achieve global targets of reducing such premature mortality.

“The collision of NCDs and Covid-19 demonstrates the need to invest in NCD prevention and control, including heart disease, as an essential foundation for national security and preparedness, ” she says.

The ministry will also continue to engage other agencies to create the necessary supportive environment for the change to happen.

“At the highest level, we have a Cabinet Committee made up of different ministries to create a supportive environment for healthy living.

“An example of government policies that support a healthier environment is the smoking ban at all restaurants and eateries, ” Dr Norhayati illustrates.

But ultimately, people must embrace a healthier lifestyle.

“Maintain an ideal body mass index (BMI) by incorporating physical activity and mindful eating as a way of life.

“Mental well-being should also be prioritised.

“For parents, invest in the health of your children even when they are in the womb, by living a good example.

“Smoking remains the leading preventable cause of death and disease globally, ” she says, adding that those looking for help can visit the ministry’s JomQuit website at jomquit.moh.gov.my

“Most importantly, get screened for NCD risk factors early to nip the disease in the bud, ” she advises.

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