[MALAYSIA] Ischaemic heart disease remains a leading cause of death in Malaysia, responsible for approximately 15% of all medically certified fatalities. Alarmingly, Malaysians suffer heart attacks at an average age of 58—nearly eight years earlier than the global norm. Yet, many young adults continue to overlook early warning signs, wrongly believing they are too young to be at risk.
Data from the National Heart Institute (IJN) highlights this growing concern, showing a 20% surge in heart-related hospital admissions among individuals aged 35 to 55 over the past ten years. Experts link this upward trend to urban lifestyles, chronic stress, and unhealthy diets, all of which accelerate cardiovascular decline.
“The belief that heart disease is confined to older adults is dangerously outdated,” said Dr Ahmad Khairuddin, a senior researcher at IJN. Consultant cardiologist Dr Lim Chiao Wen warns that failure to detect symptoms early often delays critical treatment, especially as non-communicable diseases like diabetes, hypertension, and obesity become more prevalent among younger Malaysians.
“Recognising the early signs—especially of so-called ‘mini heart attacks’—is more important than ever,” she stressed. This informal term typically refers to milder cardiac events such as unstable angina and non-ST elevation myocardial infarction (NSTEMI). While less severe than full-blown heart attacks, these episodes can have serious long-term consequences.
A 2023 study in the Malaysian Journal of Medical Sciences revealed that patients who experienced mini heart attacks had a 30% higher risk of suffering a major cardiac event within five years if left untreated. The findings underscore the urgency of early intervention and sustained monitoring, even in less acute cases.
Unstable angina occurs when restricted blood flow to the heart causes chest discomfort without permanent damage. NSTEMI involves minor heart muscle injury due to partial artery blockage, in contrast to the total blockage seen in major heart attacks.
Symptoms commonly include chest tightness, breathlessness, fatigue, dizziness, nausea, and radiating pain to the jaw, arms, neck or back. These are frequently misinterpreted as signs of indigestion, stress, or sleep deprivation, Dr Lim noted. She added that even minor episodes result in temporary interruptions to blood flow, which can leave lasting scars on the heart muscle and compromise its function.
Public awareness remains low, with many still envisioning heart attacks as sudden and dramatic events. “In reality, subtle signs—like unusual tiredness or tightness during exertion—should raise red flags,” said Dr Lim. She added that greater access to community screenings and workplace wellness initiatives could improve early detection among high-risk individuals.
Interrupted blood flow, even briefly, can damage heart tissue, reducing its pumping ability and paving the way for chronic issues such as heart failure, arrhythmia, and poor circulation.
Dr Lim cited research indicating that up to half of all patients who suffer a major heart attack had previously experienced an undiagnosed mini heart attack. Separately, 42.4% of sudden cardiac death cases with no prior diagnosis of heart disease showed evidence of previous silent heart attacks. Older individuals and those with diabetes face heightened risk, often without displaying typical symptoms, complicating diagnosis and delaying care.
Among the most significant risk factors are smoking and vaping, both of which promote blood clotting and inflammation. These effects can severely restrict blood flow to the heart.
The Health Ministry reports that 19% of Malaysians aged 15 and above are smokers, while vaping use rose to 5.8% in 2023. Both behaviours sharply increase cardiovascular risk.
The government’s Generational End Game (GEG) policy, designed to ban tobacco and vape sales to individuals born after 2007, has encountered delays but remains a crucial measure to curb future heart disease. Health experts continue to call for stricter enforcement and higher excise taxes on vaping products, which are gaining popularity among youth.
Diet also plays a decisive role in heart health. Frequent consumption of fried foods, sugary beverages, and processed meats—as well as the widespread practice of reusing cooking oil—raises cholesterol levels and contributes to arterial plaque buildup.
Coupled with sedentary habits and rising obesity rates, these dietary patterns increase cardiac strain, particularly for those already living with diabetes or high blood pressure.
Dr Lim also addressed gender-based misconceptions, noting that while oestrogen offers pre-menopausal women some protection, their heart disease risk matches men’s after menopause. Moreover, women often exhibit less conventional symptoms such as fatigue or nausea, complicating diagnosis.
Without managing underlying conditions like hypertension, high cholesterol, obesity, smoking, and diabetes, the risk of recurrent or escalating heart attacks remains high, she said.
Effective prevention requires a multi-pronged approach—medications, possible medical interventions, and sustained lifestyle changes—to protect long-term heart health.
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