Bandar Seri Begawan - The Ministry of Health (MoH) has untiredly reminded the public to practise a healthy lifestyle and to give priority to taking preventive measures against non-communicable chronic diseases.

This approach is crucial and effective as well as cost-effective in preventing and controlling chronic diseases in the country, said the Minister of Health, Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Awg Hj Adanan bin Begawan Pehin Siraja Khatib Dato Seri Setia Awg Hj Md Yusof at the World Heart Day and Open Day for Cardiology Department of the RIPAS Hospital yesterday.

He added that cardiovascular disease is also the second main cause of death in Brunei Darussalam after cancer in the past three years. Last year alone, 183 people died of cardiovascular disease, out of the total number of deaths recorded in the country, which totalled 1,235 people.

It is expected that by the year 2030, close to 23.6 million people worldwide will die of cardiovascular disease, especially heart disease and stroke. High blood pressure, diabetes, high cholesterol, obesity smoking and lack of physical exercise are the main risk factors that contribute to heart disease and stroke.

Pehin Dato Seri Setia Awg Hj Adanan added that one of the important strategies are introducing screening to detect the non-communicable diseases, including cardiovascular and risk factors at the earliest before getting too chronic and complex.

The Cardiology Department has also introduced the Cardiac CT screening programme to detect heart disease early for those who are considered vulnerable and at high risk.

"I also welcome the initiative undertaken by the Cardiology Department in introducing the Preventive Cardiology Programme. Based on the experiences through major examination, it has found that patients did not show any symptoms relating to heart disease.

It is learnt that the Cardiology Department has conducted over 2,000 Multi Detector CT (MDCT) scans, stress tests and monitored patients at the cardiology clinic. Thirty per cent of patients who did not develop any symptoms and had undergone MDCT were found to have coronary heart disease.

Such screening at an early stage helps to reduce the risks and reduce the number of heart attack cases.

Meanwhile, Dr Hj Nazar Luqman Bilgrami, Clinical Expert (Cardiology) of RIPAS Hospital said, "Today they do more than 40,000 cardiac investigations every year compared to only 10,000 in 2001."

The cardiology clinic follow-up jumped from 6,000 to 20,000 per year during the last decade.

A similar growth was also seen on therapeutic front. Four times more devices were planted now and three times more coronary interventions are done compared to a decade ago.

The Ministry of Health has also embarked on health promotional activities targetted towards healthy lifestyle and control of risk factors.

"I have no doubt that these activities and programmes would ultimately change the spectrum of cardiac disease in the country. This will take time. The full impact of these measures will only become apparent in the decades to come. But what about the large silent majority the group of high risk patients present all over Brunei, who do not have symptoms but have hidden disease/s only to be detected during opportunistic screening for Haj or medical fitness checkups or due to other reasons.

"Should we just sit and wait for events to happen or wait for opportunistic screening or could we proactively introduce programmes to detect asymptomatic heart disease in the high risk groups, prevent its progression and avoid catastrophic outcomes.

"Our experience of more than five years with cardiac CT in asymptomatic high risk patients speaks volumes in favour of this strategy At least one third of patients had hidden coronary artery disease and were treated appropriately. Now with the introduction of dual source and 320 slice CT scanners the radiation issue is taking the backstage and coronary arteries can be scanned with less than one msv radiation.

'Additionally we can look at the heart muscle perfusion that could not be done with the currently available 64 slice scanners. It would also be extremely useful in early diagnosis or exclusion of coronary artery disease in patients coming with chest pain. I would like to request the Ministry of Health to consider adding this facility in line with our programme for early detection of coronary artery disease and prevention of heart attacks."

At the ceremony, the Minister of Health officiated the Cardiology e-Kiosk and viewed an exhibition on BMI.