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Hard truths about a silent killer

If you’re super fit and you eat well, you may think you’re safe from heart disease. But that may not be the case.

Running a marathon or making a serious fitness commitment are almost a rite of passage among Hong Kong’s expats. We are a city as committed to fitness as we are to socialising. We’re also a demographic perfectly aligned to the silent killer of cardiac issues and heart disease. And while we may feel like our high fitness levels render us protected from issues like cholesterol and high blood pressure, this is simply untrue. Being fit doesn’t mean you’re in the clear when it comes to heart disease. And, interestingly, vegetarians can also suffer from cholesterol and high blood sugar.

Dr Tsang Chi Yan, Cardiologist
Dr Tsang Chi Yan, Cardiologist, Hong Kong Asia Heart Centre

In fact, Dr Tsang Chi Yan, one of the city’s leading cardiologists, warns us that he’s seeing an increase in the number of young 30-something cardiac patients here in Hong Kong. And many of these are fit specimens with green diets.

We sat down with Dr Tsang at Madame Fu in Tai Kwun to get the facts and some advice about how we can each manage our heart health and ward off the silent killer of heart disease.

What is cardiac health and heart disease?

Cardiac health is the health of your heart. The heart is a pump, it pumps blood to the body – it’s also a muscle, so it needs oxygen and nutrients. The heath of the heart has several aspects including vessels, rhythm and structure.

Heart disease is a broad term used for diseases that affect the heart. This includes narrowed or blocked blood vessels, heart rhythm issues, and defects of the heart’s structure, which you may be born with.

I’m fit; doesn’t that exempt me from the risk of heart disease or cardiac issues?

Fitness doesn’t necessarily equate to heart health. You can be fit and still have underlying heart disease. It’s less likely you’ll have problems with the rhythm and structure of your heart, but you can still face blocked blood vessels.


What’s the most common symptom of heart disease?

The challenge with heart disease is that you can have a heart problem, but no symptoms. Some patients experience chest pain – and you should see a doctor if that’s the case. It’s possible to have plaque in your blood vessels without any symptoms, and that can cause a rupture when you have a sudden effort or intense emotion. That can be deadly.

This is why it’s called a silent killer.

What role does diet play in heart health?

I encourage a diet with more emphasis on white meat, like fish, which has omega 3 fatty acids. Eat less red meat, which is mainly made up of saturated fats – these are bad for us. Try to eat more unsaturated fats, which can be found in fish and nuts. And, of course, eat more vegetables.

I’m going vegetarian; will that protect me from heart disease?

Being vegetarian isn’t necessarily healthier – vegetarians still need to monitor their diets. Some vegetarians eat foods rich in oil and starch; this means they can suffer from high cholesterol and high blood sugar. If this is the case, they too will end up with heart disease.

What’s the best way to check my heart health?

If you’re over 30 and are about to embark on a new health regime, you need to have a heart check-up. If you’re over 40, you need a check no matter your activity. The check-up will involve blood tests, treadmill monitoring and a CT scan.

Blood tests will help identify your blood sugar and cholesterol levels. This is important health information to know for adults of any age. The CT scan is important, especially for those who are fit.

When does the risk increase?

The risk increases after we turn 40; around this age, more men die of heart disease than women. Before menopause, female hormones protect women from heart disease. However, post-menopause, women’s chance of heart disease increases.

Who should I see in Hong Kong if I’m worried about my heart?

Cardiologists are heart specialists; they’ll help you with your heart concerns.

How to help ward off the silent killer

#1 Be healthy: Maintain a healthy diet and lifestyle

#2 Know your body: If you’re over 30, get a heart health check. Know your blood sugar, blood pressure and cholesterol levels.

#3 Get checked: If you’re taking on a new exercise regime or you have a high-stress job, get a heart health check with a CT scan to investigate for plaque.


See more in our Health & Fitness section

Exercises to keep you fit while travelling

Is your family eating too much sugar?

Guide to where to live in Hong Kong


This article first appeared in the April/May 2019 issue of Expat Living magazine. Subscribe now so you never miss an issue.