Understanding cardiovascular disease: Risks, symptoms, and prevention

It is not uncommon to hear about heart attacks from time to time. A healthy-looking person can suffer from heart disease without even knowing it. Thus, this year’s World Heart Day highlights the importance of understanding heart health and identifying and managing cardiovascular diseases.

Protect Your Heart

Heart disease is the leading cause of death in Malaysia, with 115 out of every 100,000 people succumbing to ischaemic heart disease (a type of cardiovascular disease) in 2019, according to data from the World Health Organization (WHO). As the top cause of death not only in Malaysia but also in many countries worldwide, WHO highlights World Heart Day annually to raise awareness about heart health and to accelerate actions to prevent, detect, and manage cardiovascular disease.

“The WHO South-East Asia Region is home to a quarter of the world’s population. This region faces a significant burden of noncommunicable diseases (NCDs), with cardiovascular diseases (CVDs) accounting for 3.9 million deaths annually, representing 30 per cent of all deaths.

“Alarmingly, nearly half (48 per cent) of these CVD-related deaths occur prematurely, affecting individuals aged 30 to 70 years and imposing significant socioeconomic burdens on families, communities, and countries,” WHO stated.

More about cardiovascular disease

Under the branch of CVD, there are not only coronary heart disease but also cerebrovascular disease, peripheral arterial disease, rheumatic heart disease, congenital heart disease, and conditions such as deep vein thrombosis and pulmonary embolism.

In an interview with Sarawak Tribune for World Heart Day this year, Dr Voon Chi Yen, Cardiologist (Interventional) and Physician at Timberland Medical Centre, emphasises that if there is a blockage in the heart, there is likely to be a blockage in other systems of the body as well.

According to the cardiologist, it is not uncommon for someone with CVD to experience erectile dysfunction due to insufficient blood supply to the organ. Since our organs are interconnected, a blockage in one area can indicate blockages elsewhere.

“From a general health perspective, when dealing with cardiovascular diseases, it is advisable to check other systems as well,” Dr Voon said, advising that men should undergo check-ups after the age of 40, while women should do so after the age of 50.

He added that, according to textbooks, CVD poses a risk to individuals as they age. As people get older, their arteries become hardened, and plaque builds up in the form of fatty deposits on the inner walls of the blood vessels.

“When we were young, our arteries were elastic and could dilate during heavy activities such as sports. However, as we age, our arteries are less able to compensate for the pressure. This is also why many adults develop hypertension. This condition is known as atherosclerosis,” shared Dr Voon.

Protecting the heart from attacks

With blockages come heart attacks, which can be fatal if not diagnosed and treated. Dr Voon shared that classic symptoms of such heart diseases include tightness in the chest or a heavy feeling in the chest. These symptoms may be triggered by exercise, anger, or stress and will ease when the triggers stop.

Prolonged symptoms that go untreated can lead to worsening blockages. In such cases, classic symptoms may recur during rest or sleep. This condition is known as unstable angina.

“If the person does not seek medical treatment, the blockage will worsen and may lead to a heart attack. The majority of patients experience mild symptoms that can last for months or even years before progressing to a more severe stage.”

However, the real challenge lies with patients who have atypical symptoms — those showing no signs of a blockage in the heart, which can lead to a silent heart attack. Dr Voon highlights that this group often comes to his clinic later than they should, and when diagnosed, they frequently experience disbelief.

“This means that when I conduct an investigation on these patients, I often find three blockages, even though they didn’t show any symptoms. This has become common these days. They are not easy to diagnose and require a specific type of investigation, such as an exercise stress test on a treadmill while recording the heart’s responses with an electrocardiograph (ECG).”

Factors, diagnosis, and prevention

Lack of sleep, anger, and having a Type A personality (characterised by stress, overthinking, perfectionism, and anxiety) are among the contributing factors to coronary heart disease, alongside age, cholesterol, diabetes, hypertension, smoking, and family history.

To diagnose the condition, Dr Voon conducts a physical examination and uses an ECG to monitor heart rates. He also performs blood tests and checks sugar levels to assess his patients’ conditions. When necessary, he recommends immediate treatment.

Meanwhile, for individuals with a healthy heart, Dr Voon encourages them to maintain a healthy lifestyle.

“By controlling the risk factors, we can delay the process. While we can’t stop aging, we can mitigate its effects by ensuring the following:”

• Make sure to maintain normal blood pressure
• Sugar levels are under control
• Stop smoking
• Maintain a healthy lifestyle, which includes exercising and balanced eating
• Ensure a good work-life balance to manage stress and lack of sleep

“And other measures that can help minimise the risk of a future heart attack,” he said.

When asked about the critical timeframe for helping a patient suffering from a heart attack, Dr Voon urges immediate medical attention.

“The critical hours are the first three, as it is essential to restore blood flow to the affected organ or tissue — either through medication, balloon angioplasty, or heart stents. The longer the wait, the lower the chances of recovery.”