Managing Chronic Diseases In The New Normal Environment

-- Photograph for illustrative purposes. freepik.com/ Racool_studio

By Muhammad Basir Roslan

KUALA LUMPUR (Bernama) – Non-communicable diseases (NCDs) are among the leading causes of death in many countries.  

NCDs are medical conditions or diseases that are not infectious and these include heart disease, diabetes, hypertension, chronic lung disease and cancer.

It is also an established fact that people with underlying health conditions, such as NCDs, have a higher risk of developing severe COVID-19 and are more likely to succumb to this highly contagious disease.

In fact, in Malaysia, the ongoing pandemic has underscored the urgency of addressing NCDs and their risk factors as NCD patients make up a staggering 70 percent of COVID-19 deaths.

Medical professionals contacted by Bernama spoke of the importance for patients, as well as their caregivers and the public, to empower themselves with the knowledge to understand their condition better and to take an active role in managing their health during these challenging times.

Dr Peter Ch’ng, Consultant dermatologist at Gleneagles Hospital Kuala Lumpur. -- Photo courtesy of Novartis

DEALING WITH HYPERTENSION

The Institute for Clinical Research, a research institute under the National Institutes of Health Malaysia, recently found that around 55 percent of COVID-19 fatalities occurred among individuals suffering from high blood pressure.

This is a relatively known fact that has been delineated in various studies as patients with cardiovascular diseases including hypertension are more likely to get a more serious manifestation of COVID-19, or even die from it.

Those who have their hypertension untreated or poorly controlled are also at higher risk compared to those whose hypertension is well controlled with medications.

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Cardiac Vascular Sentral Kuala Lumpur (CVSKL) consultant cardiologist Dr Choo Gim Hooi said many deaths related to cardiovascular diseases, for example, stroke and heart attack, have been observed during the COVID-19 pandemic.

He attributed this to patients reducing or cancelling their hospital visits and not refilling their prescriptions due to the fear of contracting COVID-19.

“I would encourage hypertensive patients to continue to see their physicians especially when they are unwell and to maintain regular follow-ups, as well as take their medications regularly,” he said when contacted recently.

Dr Choo also pointed to four key points for hypertensive patients to take note of during the pandemic, the first being practising physical distancing, wearing a mask and sanitising their hands frequently, just like everyone else in the community.

“Secondly, boost your immunity by ensuring healthy dietary choices, exercising regularly, getting enough rest and sleep, as well as watching your weight.

“Next, remember to maintain regular follow-ups with your attending physician and take your medications as prescribed. Last but not least, please protect yourself with the COVID-19 vaccine when it becomes available,” he said.

ASTHMA AND COVID-19

Individuals with respiratory illnesses such as asthma should take additional precautions as well and the best way for them to avoid complications is by ensuring their asthma is well controlled and by strictly adhering to their medication regime.

Dr Helmy Haja Mydin, Consultant Pulmonologist Pantai Hospital Kuala Lumpur. -- Photo courtesy of Novartis

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Consultant pulmonologist at Pantai Hospital Kuala Lumpur Dr Helmy Haja Mydin said that there are two types of inhaler medications for asthma patients – controller and reliever.

“A reliever is used to provide instant relief by immediately opening up your airways, but it does not address the root cause of the patient's airway inflammation. This is where the controller inhaler comes into play.

“Patients need to use this regularly every day, even if they feel well, to keep their inflammation under control. This will assist them in being less reactive to triggers or stimuli around them,” he pointed out.

He added that the pre-eminent cause for concern is that many Malaysians have poor control over their asthma due to poor medication adherence and incorrect use of the inhaler.

“If you have asthma but it is well controlled, your risk of severe complications from COVID-19 is the same as anyone else. This tells you the importance of correctly using a controller inhaler.

“Patients need to use this inhaler at the right time and with the right technique, which is particularly important in minimising the complications from COVID-19 in the context of asthma,” he said.

Dr Helmy also said that patients need to identify and avoid exposure to their known asthma triggers, even though this may be a challenge for some as disinfectants, for instance, could potentially trigger an asthma attack.

To reduce the risk of triggers, patients may consider requesting a non-asthmatic family member to assist with their house cleaning chores and avoid entering any room that is being cleaned.

MANAGING PSORIASIS

People living with psoriasis – an autoimmune disease that causes red, itchy scaly patches to appear on the skin – are also at risk of becoming impacted by the COVID-19 pandemic as frequent hand washing and sanitising can result in psoriasis flare-ups.

The Dermatological Society of Malaysia has stated that this condition affects approximately 500,000 to 800,000 Malaysians. According to the National Psoriasis Foundation, this disease may appear to be a cosmetic issue but it is an autoimmune disease that increases inflammation and causes an overproduction of skin cells, essentially when the immune system of a patient is overactive.

Psoriasis is also commonly associated with other co-morbidities such as cardiovascular diseases, diabetes and obesity, all of which place the patient at higher risk of contracting a more severe form of COVID-19.

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Dr Choo Gim Hooi, Cardiac Vascular Sentral Kuala Lumpur (CVSKL) Consultant Cardiologist. -- Photo courtesy of Novartis

Consultant dermatologist at Gleneagles Hospital Kuala Lumpur Dr Peter Ch’ng said many people may be under additional stress during this pandemic period and unfortunately, this could be a trigger point for psoriasis patients.

“It is recommended for individuals with psoriasis to manage their stress effectively. Furthermore, avoid smoking and consuming alcohol as these can also cause their psoriasis condition to worsen. Maintaining a proper sleep schedule can assist patients as well,” he said.

Psoriasis patients are also advised to wash their hands with a hypoallergenic soap instead of the regular hand sanitiser as the former reduces irritation.

Frequent moisturising can also provide relief as well, especially if the moisturiser or cream does not contain any harmful chemicals or fragrances that may cause the condition to flare up.

Edited by Rema Nambiar

BERNAMA