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Indonesia needs national hypercholesterolemia screening plan

A national cholesterol screening program can be done simultaneously with the established national disease program to strengthen our disease-prevention program as a whole.

Fistra Janrio Tandirerung (The Jakarta Post)
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North Toraja, South Sulawesi
Sat, November 25, 2023

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Indonesia needs national hypercholesterolemia screening plan Take care of your heart: A doctor listens to a patient’s heartbeat. Medical professionals advise getting routine check-ups to assess cardiovascular health and the risk factors associated with it, such as high cholesterol, high blood pressure and diabetes, to avoid suffering from sudden cardiac arrest after high-intensity exercise. (Shutterstock/Lee Charlie)

H

ypercholesterolemia, or high blood cholesterol level, is a major risk factor for atherosclerotic cardiovascular diseases such as coronary heart disease (CHD) or stroke. However, controlling blood cholesterol levels might be much more challenging than we have anticipated and requires the central government’s intervention.

High blood cholesterol levels might not always be a consequence of undisciplined dietary habits or a lack of physical activity. Instead, hypercholesterolemia might arise from inherited genetic abnormalities due to genetic mutations in some of our genes – a condition known as familial hypercholesterolemia (FH).

As a genetic disease, FH causes considerably high cholesterol levels from birth and thus places people with such a condition at risk for premature CHD. Depending on the type of mutation, a heart attack might occur from the second decade of life, although generally it occurs in the forties.

FH is the most common inherited metabolic disease. Epidemiological data is in agreement that this disease affects one in every 300 individuals. Despite most studies on FH being conducted in Europe and the United States on Caucasian samples, available data on Asian people from India, Japan, China, Hong Kong, Taiwan, the Philippines, Vietnam and Malaysia generally lead to a similar conclusion. So far, no official epidemiological FH data from large-scale research is available from Indonesia.

The statistics should be enough to concern us in two ways.

First, FH currently gains little-to-no public and scientific attention in Indonesia. Relative to the western world in general, FH in Indonesia is not much talked about, even in medical curricula and practice. Judging from currently available epidemiological data, FH might arguably be a hidden, unaddressed health problem contributing to the current cardiovascular disease situation as the number-one killer in Indonesia.

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Second, there is an urgency to evaluate the current cardiovascular disease-prevention strategy and policy in Indonesia. Thus, there is a great deal of homework to do to narrow down the knowledge and awareness gap related to FH.

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