Heart Disease
Empowering children with the knowledge of maintaining healthy lifestyle is the way forward
Early diagnosis and treatment could spare patients from the worst consequences of CVD if they took action people of the need to get screened for CVD even if they experience no symptoms . In addition , incentives for individuals to lead healthier lifestyles and undergo screening can also play an important role , especially at a time when the cost of living is rising for Malaysians .
“ Before the Covid-19 pandemic , I usually only spent about RM�00 a month on kitchen items , including baby milk , but now it has increased to RM600 for the same things … not to mention other expenses such as babysitting , housing and vehicle loan payments ,” Muhammad Hani told The Malaysian Reserve . When people struggle to make ends meet or find free time because of long working hours , they ’ re also unlikely to be able to eat healthily or exercise .
Dr Yong believes it ’ s paramount to start educating people from a young age by incorporating health literacy in school curriculums . “ I believe empowering children in school with the knowledge of maintaining a healthy lifestyle is the way forward to curb the everincreasing burden of CVD ,” he said .
He added that early diagnosis and treatment could spare patients from the worst consequences of CVD if they took action , but some people diagnosed with problems like high cholesterol didn ’ t want to make lifestyle changes or start taking medications and then ended up having to undergo much more invasive treatment . This was the case with one of his patients who required coronary artery bypass surgery for severe disease of the main heart vessels .
“ This is a very common scenario that we encounter during our clinical practice . If the appropriate therapy was started to control his cholesterol levels , we could have prevented a major open-heart surgery ,” he said .
Such examples highlight that early identification of people likely to develop C�D is crucial to effectively tackle the rising incidence of the disease . To achieve this goal , the white paper recommends a centralised electronic medical record system to screen and monitor at-risk groups to increase early diagnosis and start treatment in a timely fashion . Key risk factors to consider should include age , gender , cholesterol levels , blood pressure , diabetes , and smoking .
“ This will ensure a targeted CVD management program is accessible to the sub-population that has higher risk of putting burden to the healthcare system ,” the white paper reads .
The authors also call for improving access to the most innovative treatments to reduce the risk of CVD while lowering the long-term cost of care for patients . Some of these treatments may even prevent hospitalisations and work absenteeism , they argue .
Two CVD medications that could help Malaysians prevent serious cardiovascular problems are bempedoic acid and PCSK9 inhibitors , which were developed in recent years to lower LDL cholesterol . The former can decrease heart disease complications like heart attacks and the need for procedures like bypass operations or stent placements . Most importantly , it provides an alternative to statins , the most prescribed type of anti-cholesterol medication that some patients can ’ t tolerate due to their side effects , including muscle pain . The latter can lower LDL cholesterol and reduce the risk of death due to CVD events on their own but can also be prescribed in combination with statins to help selected patients cut their risk of heart attack , stroke , and hospitalisation for heart-related problems .
Unfortunately , there are roadblocks to the availability of both medications in Malaysia .
“ Bempedoic acid is still new and currently not available in Malaysia as it has not been registered locally , though I understand this process is on-going ,” said Dr Yong . “ PCSK9i are currently available in the Malaysian market but , due to the high cost , many patients could not have access to it . It is also currently not reimbursable in the public healthcare system .”
The authors of the white paper are confident that these strategies , when implemented through public and private partnerships , can stem the tide of CVD in the country , offering positive health and financial improvements for several decades . n
44 ISSUE 5 | 2023 GlobalHealthAsiaPacific . com