Don’t ignore the warning signs: Heart disease is no longer just for the elderly

March 21, 2025

Dr Yew Kuan LeongResource person: Dr Yew Kuan Leong, Consultant Cardiologist, Bukit Tinggi Medical Centre (BTMC)

We are seeing a concerning trend where heart disease is affecting Malaysians in their 40s and even 30s. One in four cases in Malaysia involves individuals under 50, which is alarming.

Heart disease remains the leading cause of death worldwide, with atherosclerotic cardiovascular disease (ASCVD) responsible for over 15 million deaths each year. Worryingly, Malaysians are experiencing ASCVD at a much younger age compared to other countries – about ten years earlier on average, placing a significant burden on public health.

Right now, we are seeing a concerning trend where heart disease is affecting Malaysians in their 40s and even 30s. One in four cases in Malaysia involves individuals under 50, which is alarming.

A silent killer called high cholesterol

One of the biggest contributors to ASCVD is high cholesterol, or hyperlipidaemia, which occurs when excessive lipids accumulate in the bloodstream. Often referred to as a silent killer, high cholesterol presents no immediate symptoms but can lead to severe cardiovascular issues, including heart attacks and strokes.

Many people assume that if they feel healthy, they are safe from heart disease. That is a dangerous misconception. The only way to know your cholesterol levels is through regular screening.

Cholesterol is produced both by the body and through diet. While lifestyle choices play a crucial role, genetics also determine cholesterol levels. About 70-80% of cholesterol is produced by the liver, meaning even individuals with a healthy diet and active lifestyle can still have high cholesterol.

Are you at risk?

Doctors classify risk factors for heart disease into two categories: modifiable and non-modifiable.

(1) Modifiable risk factors – These include diet, exercise, smoking, and overall lifestyle habits. Regular physical activity and a diet low in saturated fats can help manage cholesterol levels.

(2) Non-modifiable risk factors – These are beyond an individual’s control, such as age, gender, genetics, and family history.

Some individuals inherit a condition called Familial Hypercholesterolemia (FH), which causes dangerously high cholesterol levels from a young age. One in 250 people has FH, but it often goes undiagnosed until serious complications arise.

Taking control of your heart health

Given the high prevalence of heart disease in Malaysia, proactive management is essential.

(1) Get screened regularly – Healthy adults should check their cholesterol levels every 6 -12months, but those with risk factors should do it more frequently.

(2) Know your numbers – LDL-C (bad cholesterol) should ideally be kept between 1.4 – 2.6 mmol/L depending on your risk level.

(3) Adopt a heart-healthy lifestyle – This includes a balanced diet, regular exercise, and quitting smoking.

(4) Consider medical treatment when necessary – For those with high cholesterol, lifestyle changes alone may not be enough. There are effective medications and newer innovative therapies that significantly lower LDL-C levels and reduce cardiovascular risks. However, it is crucial to follow your doctor’s recommendations and not self-adjust medication.

Heart disease is preventable, but only if you take action early. We need to change the mindset that heart disease is an ‘old person’s problem.’ Young people are at risk too, and prevention should start now.

If you haven’t had your cholesterol checked recently, now is the time. Speak to your doctor about your heart health and take proactive steps to protect yourself from cardiovascular disease.

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Category: MJN enews, Top Story

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