17 March 2011

Today, we celebrate World Heart Day by paying extra care and attention to the most vital organ in our body – the heart.

EACH year, about 17.5 million lives are claimed by the world’s largest killer – heart disease and stroke. In Malaysia, heart disease has been the number one killer for the past three decades. This statistic goes across the globe, making heart disease the most common cause of death worldwide.

This is why World Heart Day was created, to raise public awareness of risk factors for heart disease and stroke as well as to promote preventive measures to bring this alarming number down.

Today, as we celebrate World Heart Day, organised by the World Heart Federation members and partners, let us take a moment to think how we can avoid becoming part of the heart disease statistic.

Your personal risks

How you treat your body will determine how susceptible you will be to heart disease in the future. It is heartening to know that important risk factors like high cholesterol, high blood pressure, diabetes, obesity and smoking are largely preventable. Knowing how to lower or eliminate each risk will help you remain in the best of health.

RISK #1: High cholesterol

Coronary heart disease is caused by cholesterol and fat deposition in the walls of the arteries (known as plaque), causing obstruction to blood flow. Sometimes the plaque may crack, giving rise to blood clot formation which obstructs the blood flow in the blood vessel completely. When this happens in the coronary arteries, a heart attack ensues.

One of the ways to lower your cholesterol is to have a daily diet that is low in cholesterol and saturated fat, and high in fibre. Be sure to include substantial servings of vegetables, fruits and whole grains such as oats everyday – all are good sources of fibre.

The soluble fibre in oats (called beta glucan), has been clinically proven to help lower cholesterol in the blood. In 1997, the US Food and Drug Administration (FDA) approved its first ever health claim: “Diets high in oatmeal or oat bran and low in saturated fat and cholesterol may reduce the risk of heart disease.”

Cholesterol from the blood is also used to make bile, which is then stored in the gallbladder and secreted into the intestines in order to digest and absorb the fats that you have eaten. When you eat oats, the soluble fibre binds together with the bile and both are subsequently excreted through the bowel. As a result, your liver “takes up” more cholesterol from the blood to make more bile. This effect will then lower the amount of cholesterol in the blood.

RISK #2: High blood pressure

Uncontrolled high blood pressure can expose you to a host of complications, such as stroke, heart attack, heart failure as well as kidney failure. Known as the silent killer, high blood pressure is often present without any symptoms.

Lifestyle plays an important role in avoiding high blood pressure or reducing it. One of the most crucial changes can be made by merely making a small reduction of sodium intake in your diet. Cut back on the salt gradually – your palate will adjust overtime. Use natural herbs or spices, rather than salt, to add more flavour to your foods.

RISK #3: Diabetes

The third National Health & Morbidity Survey in 2006 showed that 14.9% (i.e. one in seven) of adult Malaysians have diabetes. It is estimated that diabetes could affect 25% of Malaysians by the year 2020.

Managing your blood glucose level is very important in keeping heart disease at bay. A diabetic is often on the fast track to suffer from a heart attack due to elevated blood glucose levels.

However, glucose levels can be controlled by watching what you eat. Make an attempt to implement dietary changes such as opting for kurang manis or less sugar when dining at your favourite mamak joints. Do not forget the hidden sugar contained in foods such as sambal or gulai. Less is more. Little changes can go a long way in ensuring that your blood glucose level stays at a healthy level.

RISK #4: Obesity

Obesity increases your risk of developing heart disease. In order to control your weight, remember to have a balanced diet. Watch what you eat; after all, you are what you eat.

Even individuals who are overweight but not really obese are at increased risk. Losing as little as 5% to 10% of your body weight may alleviate many of the problems linked to being overweight. Moving toward a more physically active life is beneficial and usually produces great rewards. This does not necessarily require a rigorous exercise regime – merely walking briskly for 30 minutes daily can produce an effect. Take the stairs instead of the lifts, park your car further, walk your pets and engage in sports that you enjoy.

Be conscious of your eating habits and aim to improve them. Include fruits, vegetables and whole-grain foods in your diet. These foods will fill you up and are lower in calories than foods full of oils or fats.


There has been a tremendous amount of literature written on the impact of smoking on a person’s health and wellbeing. According to the Minstry of Health’s Anti-Smoking Campaign (Tak Nak), it is estimated that smoking-related illnesses, including coronary heart disease, will kill 10 million Malaysians by 2030.

A person’s risk of heart disease greatly increases with the number of cigarettes he or she smokes. People who smoke a pack of cigarettes a day have more than twice the risk of heart disease compared to non-smokers.

If you are a smoker, make a pact to reduce the amount of cigarettes you smoke a day and get smoking out of your life. Better still, go “cold turkey” if possible. It will reduce your risk of developing heart disease, and prolong your life and lives of those around you.

If you are a non-smoker, avoid inhaling other people’s smoke as non-smokers who are exposed to second-hand smoke at home or at work have an increased risk of developing heart disease by 25% to 30%.

Desirable blood values

The following are ideal blood values you should have to ensure reduced risk of heart disease:

Total cholesterol – less than 5.2 mmol/L

LDL-C – less than 3.3 mmol/L (< 1.8 mmol/L for high risk individuals)

HDL-C – more than 1.03 mmol/L (males); more than 1.3 mmol/L (females)

Triglycerides – less than 1.7 mmol/L

Body Mass Index – 18.5 – 24.9 kg/m2

Waist circumference – Men: less than 102cm (less than 90cm Asians); Women: less than 88cm (less than 80cm Asians)

Blood pressure – less than 130/80mm/Hg

Blood glucose – less than 5.6mmol/L

Emerging risk factors

Other factors may also play a role in increasing the risk of cardiovascular disease, namely triglycerides and HDL cholesterol levels, homocysteine, hsCRP, Lp(a), and fibrinogen.

High triglycerides and low HDL cholesterol levels have been shown to increase the risk of heart disease, therefore it is important to address these parameters as well with a low carbohydrate diet and regular exercise to keep a healthy weight.

The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP 3) guidelines recommend that elevated triglycerides and low HDL cholesterol levels should be treated once the LDL cholesterol has been controlled.

High levels of homocysteine, hsCRP, Lp(a), and fibrinogen are also associated with an increased risk of heart disease. In the Jupiter trial, individuals with high hsCRP (more than 2mmol/l) were associated with a higher risk of heart disease compared to individuals with low hsCRP, though the LDL cholesterol levels were low.

This World Heart Day, why not listen to what your body and heart is telling you? Pay close attention, and do what is best for your heart in the long run. Know your risks, and you can be on your way to great health.

World Heart Day 2010

This year, the Heart Foundation of Malaysia is celebrating World Heart Day today (today) at Taman Titiwangsa. Join us in this fun-filled happening event to care for your heart.

The Heart Foundation of Malaysia is a non-profit, non-governmental organisation that was established in 1982 with the help of a few dedicated and concerned lay people who were determined to make an impact on the control of heart and blood vessel disease.

The aim of the Heart Foundation of Malaysia is to help reduce the rising incidence of heart disease in Malaysia through various channels such as public education and implementation of heart health programmes that is designed to encourage healthy lifestyle habits.

This article was published in www.thestar.com.my on 26 September 2010.