Chest pains and shortness of breath are common signs of a heart attack which shouldn't be taken lightly, regardless of a person's age.
PETALING JAYA: Heart disease is the main culprit in cutting short the lives of Malaysians - it’s the number one cause of premature deaths in the country.
Premature deaths are lives that are lost between the ages of 30 and 69, below Malaysia's average life expectancy of around 75.
A total of 95,266 deaths were recorded in 2022 within this age group, according to data in the Statistics on Causes of Death Malaysia 2023 report.
Heart disease was the top killer, making up 18.4% of medically certified deaths in that year, based on the report by the Department of Statistics Malaysia.
In second place was pneumonia, followed by cerebrovascular diseases like stroke, Covid-19 infection and transport accidents.
Medically certified deaths are deaths that are verified by a medical officer or coroner. Non-medically certified deaths are verified by informants without any medical qualifications such as individuals or police officers.
Younger hearts at stake
It’s a worrying trend, but more younger people are getting heart attacks today compared to five years ago, observes National Heart Institute cardiologist Dr Abdul Ariff Shaparudin.
“Heart disease has been the top cause of death in Malaysia for many years.
“But these days, it is hitting younger people like parents of young children and those who are single.
“The average age of a patient who comes in for treatment is around 40 to 50.
“But in recent years, more younger patients are coming in, with heart attacks striking those in their early 30s and even late 20s,” Dr Abdul Ariff said, drawing from his personal experience.
A common reason why heart disease was affecting younger people was the smoking habit picked up by patients since young.
“Some are such heavy smokers that by the time they reach the age of 30 or 40, they have smoked more than other older people,” he said.
To curb smoking, there are measures underway including the tabling of a Bill to ban the sale of tobacco products, smoking substance or substitute tobacco products to minors.
On Tuesday (Nov 28), the revised Control of Smoking Products for Public Health 2023 Bill was tabled for the first reading in the Dewan Rakyat, albeit without the generational end-game (GEG) element.
Nevertheless, the proposed law will prohibit underage smokers from vaping or purchasing vape products.
ALSO READ: Anti-smoking bill prohibits minors from buying and using vape
Another reason for heart disease to affect younger people was that this productive age group was often busy working, with little to no time to take care of themselves like eating a healthy diet and exercising.
Aside from poor lifestyle choices like unhealthy eating habits, Malaysian Medical Association president Dr Azizan Abdul Aziz said the lack of good quality sleep was also an area that can contribute to heart disease.
“This is an area that’s often overlooked.
“Poor sleep hygiene can also raise the risk of not only heart disease but stroke, diabetes, obesity, hypertension, kidney disease and depression.
“According to a report in the Asian Journal of Medicine and Health Sciences, nine in 10 Malaysians experience some level of insomnia and have one or more sleep problems,” she said.
On pneumonia being the second top killer, Dr Azizan said the risk of getting the disease can be increased due to poor hygiene, weakened immune system, smoking, Covid-19 and existing conditions like asthma.
“Alcoholism can also have adverse effects on the immune system which can increase risk of infections such as pneumonia.
“Young children and the elderly have a higher risk of getting pneumonia too,” she added.
Breast cancer, accidents and Covid-19
Of the total number of premature deaths, most were involving men (63.8%), compared to women (36.2%).
Between both genders, the top causes of premature death had a slight difference.
While the biggest killers for both were heart disease, pneumonia and cerebrovascular disease, the fourth most common cause of death for women was breast cancer.
For men, the top fourth spot went to transport accidents.
In general, Dr Azizan said the increasing number of cancer cases was concerning.
“Ultra-processed food has been associated with a higher risk of developing cancers.
“The risk of breast cancer can be reduced through observing a diet of whole or unprocessed food, regular exercise, quality rest, quitting smoking, eliminating or reducing alcohol consumption and effectively managing stress.
“Adult women of all ages are encouraged to also perform breast self-examinations at least once every month - an important step as better outcomes can be achieved through early detection,” she urged.
On Covid-19 as a top cause of death for both genders, Dr Azizan said the coronavirus was still a public health threat.
This was especially true for people with comorbidities who can be at risk of severe symptoms as well as death.
“Nevertheless, it’s possible the majority of Malaysians have developed strong immunity against the virus.
“This is due to the high vaccination rate as well as natural immunity developed through infection,” she said.
Across the states
Selangor recorded the most number of premature deaths last year, with 15,929 fatalities or 16.7% of the national total.
This is followed by Johor (11,787 deaths) and Perak (9,513).
While Selangor charted the highest number of deaths, the state with the highest premature mortality rate is Kedah.
The northern state had nine deaths for every 1,000 population aged between 30 and 69 - higher than the national premature mortality rate of 6.3.
Heart disease reigned as the top cause of premature death in most states, except for Sabah where pneumonia is the number one killer.
Don’t ignore the signs
Premature deaths can be avoided, but it is up to everyone to be aware of their own health and not be afraid to take action.
For Dr Abdul Ariff, he observed that many younger people tend to “downplay” symptoms of heart disease like chest pains, believing that they were too young to get it and dismissed the aches as temporary.
“Others are also scared of going to the doctor to get it checked,” he said, adding that there were also some who assumed they wouldn’t have heart ailments as they were physically active.
However, Dr Abdul Ariff said even athletes can still develop heart disease and advised the public to go for regular health screenings.
“If you are 30 and above, you must already know your baselines like your cholesterol and blood sugar levels so that you are aware of what you need to do,” he urged.
With heart disease taking the top spot, Dr Abdul Ariff said it was important to take warning signs like chest pain and shortness of breath seriously.
“You should be able to notice them as it is not normal to have chest pain without reasons.
“It feels like something heavy is crushing on your heart, and it is a throbbing pain all over the chest,” he said.
The tricky part is that some who lead healthy lifestyles may also get heart disease due to factors like family history and should also go for regular health checks.
“No matter how healthy you believe you are, you still need to know your heart,” he added.
Dr Azizan urged every individual and especially parents to lead their children by example with daily healthy lifestyle habits.
“Healthy habits need to be instilled among children from a young age so that they continue to live healthily in adulthood,” she said.
