From Left: Ms Celeste Lau, Assistant Director, Dietetics; Dr Lim Bee Chian, Consultant Cardiologist; and Ms Nathalie Goh, Physiotherapist, during the Sunway Medical Centre in partnership with Novartis Malaysia media roundtable
Malaysians who exercise regularly and maintain a healthy diet may still face a significant risk of heart attack and stroke if elevated “bad” cholesterol remains uncontrolled, health experts have warned.
The warning comes as Malaysia continues to grapple with high levels of cholesterol and cardiovascular disease, with experts stressing that lifestyle changes, while important, may not be sufficient for people already at high risk.
An estimated 7.6 million Malaysian adults — about one in three — have high cholesterol, while four in 10 have elevated low-density lipoprotein cholesterol (LDL-C). About half are unaware of their condition because high cholesterol generally has no symptoms.
The issue was highlighted at the Keep it Low, Keep it Stable Media Roundtable held in conjunction with World Heart Day.
Dr Lim Bee Chian, consultant cardiologist at Sunway Medical Centre, Sunway City, said the body’s own cholesterol production is an important factor that Malaysians need to understand.
“As the liver produces 80 per cent of cholesterol, relying on lifestyle changes alone may not be sufficient for high-risk individuals to bring LDL-C down to recommended targets,” she said.
“In these instances, medical treatment is often required to achieve control, alongside diet and exercise, to meaningfully reduce cardiovascular risk.”
The liver produces most of the cholesterol circulating in the bloodstream, meaning factors such as genetics and the body’s own biology can contribute to high LDL-C even among people who eat well and exercise regularly.
Experts said this makes it important for individuals to know their cardiovascular risk and the LDL-C level appropriate for their particular risk profile.
For people at high risk, the recommended LDL-C target is typically below 1.8 mmol/L, with those at very high risk requiring even lower levels.
The emphasis, Dr Lim said, should not simply be on lowering cholesterol but keeping it low and stable over the long term.
The roundtable promoted what it called a “Heart Health Trifecta” — diet, exercise and medical treatment where prescribed — as three complementary pillars of cardiovascular risk management.
Celeste Lau, assistant director of dietetics at Sunway Medical Centre, said healthier eating did not have to involve complicated changes.
“Heart-healthy eating does not need to be complicated,” she said, urging people to make small, consistent changes, including reducing saturated fat and choosing healthier food alternatives.
Physiotherapist Nathalie Goh said physical activity should also be tailored to an individual’s health condition, particularly for those with existing cardiovascular disease.
“For high-risk individuals and patients with cardiovascular conditions, physical activity should be appropriately structured to safely elevate the heart rate,” she said.
She stressed that consistency and suitability were more important than exercise intensity alone, with activities ranging from supervised rehabilitation to walking groups and individually tailored exercise programmes.
The discussion also highlighted advances in cholesterol-lowering treatment, including statins, ezetimibe, PCSK-9 inhibitors and newer RNA-based therapies for patients who remain above recommended LDL-C targets despite conventional treatment.
Sanjeev Balachandran, country president of Novartis Malaysia, Brunei and Asia Emerging Markets, said Malaysia needed to strengthen its approach to cardiovascular prevention.
“Managing heart disease requires a holistic approach, and the statistics clearly show that what we are currently doing is not enough,” he said.
He called for greater awareness and action to ensure that people at risk are identified, treated and supported in keeping their cholesterol levels under control over the long term.
Malaysians can assess their cardiovascular risk and corresponding LDL-C target through the Unblocked Movement microsite and are encouraged to discuss their results and appropriate management options with their doctors.
The campaign’s central message is simple: lowering cholesterol is not necessarily a one-time achievement. For those at elevated risk, keeping LDL-C low and stable may be the more important long-term goal. – IN.Deed Communications
