Jeyamalar Rajadurai¹*, Wan Azman Wan Ahmad², Hapizah Nawawi³, Choo Gim Hooi⁴, Ng Wai Kiat⁵, Rosli Mohd Ali⁴, Al Fazir Omar⁴, Sazzli Kasim⁶ and David Quek Kwang Leng⁵

¹Subang Jaya Medical Centre, Selangor, Malaysia
²Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
³I-PPerForM and Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh Campus, Malaysia
⁴Cardiac Vascular Sentral, Kuala Lumpur, Malaysia
⁵Pantai Hospital, Kuala Lumpur, Malaysia
⁶Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh Campus, Selangor, Malaysia

*Corresponding Author: Jeyamalar Rajadurai, Subang Jaya Medical Centre, Selangor, Malaysia.

Received: January 24, 2022; Published:

Abstract

Cardiovascular disease (CVD) is a major health problem worldwide. Primary preventive population-based strategies aimed at improving global cardiovascular (CV) health is being advocated universally. In addition, specific CV risk factors need to be addressed. This paper focusses on the management of hypercholesterolaemia from a Malaysian perspective and also discusses the newer lipid lowering agents. In individuals at low and intermediate CV risk, lifestyle modification alone may suffice. This encompasses a pragmatic and healthy diet, weight management and increased physical activity. In individuals at high and very high CV risk however, in addition to lifestyle modification, drug therapy is almost always necessary to achieve the target Low Density Lipoprotein Cholesterol (LDL-C) levels which have been shown to improve CV outcomes. In clinical trials, very low LDL-C levels (< 1.4 mmol/l) have been shown to retard progression and sometimes even result in regression of atherosclerotic plaques. Statins are the first-line drugs because there is robust data that they are both effective and safe. Such low target LDL-C levels (< 1.4 mmol/l) however are sometimes not achievable despite maximally tolerated statin therapy and lifestyle modification. The addition of ezetimibe and/or Proprotein convertase subtilisin/kexin type 9 Inhibitors (PCSK9-i) to statins may be necessary to achieve these targets.

Keywords: Cardiovascular Disease; Hypercholesterolaemia; Statins; Familial Hypercholesterolaemia; Statin Intolerance; Ezetimibe; PCSK9-inhibitor

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Citation

Citation: Jeyamalar Rajadurai., et al. “Management of Hypercholesterolaemia for Cardiovascular Risk Reduction: A Malaysian Perspective". Acta Scientific Medical Sciences 6.5 (2022): 00-00.

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Copyright: © 2022 Jeyamalar Rajadurai., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.