Challenges of the Cardiovascular Disease Epidemiology and Prevention forum

World Health Organisation (WHO) statistics show that each year, 17.5 million people die from cardiovascular disease (CVD) ‒ an estimated 31% of all deaths worldwide. More than 75% of CVD deaths occur in low- or middle-income countries such as Malaysia. Not surprisingly, 80% of all these CVD deaths are due to heart attacks and stroke.

The Jeffrey Cheah School of Medicine and Health Sciences at Monash University Malaysia sheds light on this issue through a forum on the Challenges of the Cardiovascular Disease Epidemiology and Prevention at its campus’ Plenary Theatre on Saturday, 10 June 2017 from 10.30am to 12.30pm.

Moderated by Dato’ Dr Ahmad Farouk Musa, the forum's panellists comprise Imperial College London, UK, Professor of Preventive Cardiovascular Medicine, Professor Neil Poulter; Northwestern University Feinberg School of Medicine, Professor of Preventive Medicine, Professor Darwin Labarthe; Chief Clinical Officer of the National Heart Institute, Datuk Dr Aizai Azan Abdul Rahim; and Head of Cardiothoracic Surgical Services of the Ministry of Health Malaysia, Dato’ Dr Mohd Hamzah Kamarulzaman.

In his welcome speech, Monash University Malaysia President and Pro Vice-Chancellor, Professor Andrew Walker said there are many positive impacts from the modernisation and development in Southeast Asia, but there are also important challenges as we lead the way.

“We are now facing some new health challenges of affluence and lifestyle as people work, exercise, and eat in different ways. We are seeing new health challenges, and CVD is the main cause and the common cause of death here in Malaysia,” Professor Andrew Walker said.

The rapidly increasing CVD rates in low- and middle-income countries are said to include high exposure to risk factors such as tobacco use, unhealthy diet, and lack of physical activity — and less access to effective and equitable healthcare services. These factors lead to less control of hypertension, diabetes and hyperlipidemia and as a result, leads to higher incidence of CVD.

On a global front, WHO recognises the burden of non-communicable diseases (NCDs) and together with the World Heart Federation, they are committed to the 25 by 2025 goal which aims to reduce mortality from premature CVD by 25% before 2025.

“Because the epidemic is global, they reason out that the solutions must also be global. Their target is to reduce alcohol consumption by 10%, physical inactivity by 10%, salt intake by 30%, tobacco use by 30%, raised blood pressure by 25%, and hope that there is no increase in obesity,” Datuk Dr Aizai Azan Abdul Rahim said in his presentation.

He added that at the same time, they want to ensure that 80% of the medications are available and accessible to the population, and 50% of people suffering from heart attack and stroke should receive appropriate drug therapy and counselling.

Ultimately, Datuk Dr Aizai Azan Abdul Rahim believes the only real enemy of disease is knowledge. Education of what we know will have a bigger impact on health and disease than a single drug or technology that is likely to be introduced within the next decade.

Perhaps, it is time to reframe our approach to the problem ‒ and Professor Darwin Labarthe said we need to rethink about health gestation, development and ageing as primary contributors to the improvement in the prevalence of ideal cardiovascular health (CVH) in the first place.

“This supplements primary prevention by primordial prevention thereby blocking the progression of poor CVH. I would argue promoting and preserving ideal CVH is an approach that applies primordial prevention. It begins at the beginning, it expands throughout the life course, it relieves reliance on remedial strategies alone, and it suggests an end game for heart diseases and stroke,” he said.

“It might not be an easy topic to the general population looking at the complexity of the slides and statistics, but the speakers have managed to deliver the crux of the knowledge and understanding very well to the audience who were mainly from the medical fraternity,” Dato’ Dr Ahmad Farouk Musa shared in his closing talk.

He also added that Monash University Malaysia has managed to set a new standard in making this sort of academic forums to be appealing, and he believes the university will be able to come up with public forums more regularly in the future. This will in turn allow Monash to not only be known as a prestigious academic institution, but also a prominent centre of public health education.