TheHEALTH July/August 2026 | Page 9

July-August. 2026 | The HEALTH

COVER STORY

KNOW YOUR NUMBERS

For most people, the fundamentals of heart health are familiar: eat well, exercise regularly, maintain a healthy weight, avoid smoking and keep major cardiovascular risk factors under control.

But knowing those risk factors is equally important.

Malaysian guidelines recommend cholesterol screening for adults from age 30, while people at higher risk of cardiovascular disease should begin screening from 18.

Those with a family history of premature heart disease, diabetes, hypertension, obesity or a history of smoking may need earlier or more frequent assessment.

“ If you have significant risk factors or a family history of heart disease, do not wait until you experience a cardiovascular event,” Dr Rosli advised.“ Get checked earlier.” An initial assessment may include cholesterol testing, blood pressure measurement and diabetes screening. From there, doctors can assess an individual’ s overall cardiovascular risk and determine whether further investigation is appropriate.

THE HEART HEALTH TRIFECTA

For Datuk Dr Rosli, prevention and cholesterol management ultimately rest on three complementary pillars: healthy eating, regular physical activity and, when medically appropriate, treatment.

“ These three components should not be viewed separately,” he said.

“ Lifestyle changes remain the foundation, but for some people, additional treatment may be needed to help achieve and maintain recommended LDL-C levels.”

Importantly, there is no single LDL-C target for everybody.

Targets depend upon a person’ s cardiovascular risk. Current Malaysian recommendations generally call for LDL-C below 1.8 mmol / L for people at high cardiovascular risk and below 1.4 mmol / L for those at very high risk.

“ The earlier LDL-C is controlled, the lower it is maintained and the longer it stays under control, the better the outcomes are likely to be,” he said.

STAYING THE COURSE

The paradox of cholesterol management is simple: when people cannot feel anything wrong, they may find it difficult to accept that something needs to be managed.

That makes understanding the condition crucial.

“ The patients who ask questions and understand their condition are usually the ones who stay committed to managing it,” Datuk Dr Rosli said.

Treatment is individualised according to cardiovascular risk, LDL-C levels and treatment goals. Lifestyle measures remain fundamental, while doctors may recommend cholesterol-lowering medication when additional LDL-C reduction is required.

Malaysian guidelines recommend statins as first-line treatment, with combination therapy considered when necessary to reach LDL-C targets. Other therapies, including injectable options, may be considered for appropriate patients whose LDL-C remains above recommended levels despite oral therapy or who cannot tolerate statins.

But the larger message goes beyond medication.

It is about changing the way Malaysians think about heart disease— from treating something after it happens to identifying risk before it does.

“ Don’ t be complacent or remain ignorant,” Datuk Dr Rosli said.

“ Heart disease can remain silent for years. The only way to know is to get checked, understand your risk and have an informed discussion with your doctor about the best way to protect your heart health.”

Perhaps that is the most important change of all.

Being young is not a heart-health strategy. Neither is looking healthy.

Knowing your risk is.- The HEALTH

Too young for heart disease? The numbers say otherwise

HEART disease has an image problem.

Mention a heart attack and many people still picture someone considerably older— perhaps overweight, sedentary and with years of unhealthy living behind them.

story.

Malaysia ' s cardiovascular numbers tell a rather different

Research into the country ' s cardiovascular disease burden has warned that symptoms are appearing earlier in life, with significant numbers of patients presenting with acute coronary syndrome before the age of 50. The risk factors are also widespread. As of 2019, about four in every 10 Malaysian adults had hypercholesterolaemia, approximately three in 10 had hypertension, while one in five had diabetes. Perhaps more worrying is that many did not know it. Diagnosis rates among Malaysians with cardiovascular risk factors remain a concern, particularly for high cholesterol— a condition that can exist for years without obvious symptoms.

And the consequences continue to show up in Malaysia ' s mortality statistics.

The Department of Statistics Malaysia reported that 17,421 people died from ischaemic heart disease in 2024, representing 13 per cent of all medically certified deaths and making it the country ' s principal cause of medically certified death.

Among Malaysians aged 41 to 59, ischaemic heart disease accounted for 17.6 per cent of deaths.

This is not a new phenomenon. DOSM ' s historical data show that ischaemic heart disease was Malaysia ' s principal cause of death throughout the decade from 2010 to 2019. The message behind the numbers is straightforward. Cardiovascular risk does not suddenly begin at 50 or 60. High cholesterol, hypertension and diabetes can develop quietly much earlier, steadily increasing cardiovascular risk long before symptoms appear.

That makes the question less about whether someone feels healthy and more about whether they actually know their numbers.- The HEALTH

The heart may be silent about its risks. The numbers need not be.