Medication, not ethnicity, controls cholesterol levels

Dr Tan Ngiap Chuan, the director of the department of research at SingHealth Polyclinics, observed that many patients with high cholesterol continue to be resistant to starting medication.
Dr Tan Ngiap Chuan, the director of the department of research at SingHealth Polyclinics, observed that many patients with high cholesterol continue to be resistant to starting medication.PHOTO: COURTESY OF SINGHEALTH

Patients who follow prescription meet treatment goals: SingHealth study

Ethnicity is far less important than how diligent patients are in taking their pills when it comes to treatment for high cholesterol, according to a new study by SingHealth Polyclinics.

The survey of 1,093 Chinese, Malay and Indian polyclinic patients found that all patients - regardless of ethnicity - who took their simvastatin drug as prescribed achieved the desired results.

"It is a very significant takeaway from the study," said Dr Paul Goh Soo Chye, clinic director of Tampines Polyclinic (SingHealth). "If you take your medication regularly, you will achieve your treatment goal," said Dr Goh who was involved in the study.

There was also a strong correlation between adherence to other lipid-lowering medication regimens and successful treatment - 81.8 per cent of Chinese, 69.7 per cent of Indian and 69 per cent of Malay patients who reached their treatment goals said they took their pills as instructed.

Dr Tan Ngiap Chuan, the director of the department of research at SingHealth Polyclinics, observed that many patients continue to be resistant to starting medication. "It's always better to discuss your concerns with the doctors and nurses than to secretly skip dosages," he advised.

DO AS DOC SAYS

It is a very significant takeaway from the study. If you take your medication regularly, you will achieve your treatment goal.

DR PAUL GOH SOO CHYE, clinic director of Tampines Polyclinic (SingHealth).

Dr Tan, who led the study, said the findings could prompt doctors to prioritise discussion of a patient's medication regimen during doctor-patient consultations. He said: "We usually focus on other lifestyle factors first. We may switch the order now."

High cholesterol remains the prime risk factor for atherosclerosis - the thickening of artery walls from deposition of fatty material - and other vascular diseases. These can go on to cause strokes and heart complications.

But ethnicity became a factor in other lifestyle changes required to control blood cholesterol.

The study, which was sponsored by the Singapore Heart Foundation, found the influence of changes in smoking, diet and exercise varied across ethnic groups.

For example, Indian patients saw better results when they changed their diets than Chinese and Malay patients.

Similarly, getting regular exercise did not have the same impact on Malay and Indian patients as the Chinese, who were more likely to get positive results if they were active four times a week.

In general, the proportion of Chinese, Indian and Malay patients who achieved their cholesterol goals were 78.3 per cent, 68.5 per cent and 67.9 per cent respectively.

Faced with the apparently counterintuitive results, Dr Tan said further research will be conducted into the reasons for ethnic disparities.

Differences notwithstanding, patients should be like Madam Lee Whee Kheng, 65, a Tampines Polyclinic (SingHealth) patient who has successfully managed her cholesterol level for more than 10 years.

The housewife recommends a holistic approach to taking charge of heart health. "I eat more fish soup and yong tau foo instead of burgers, and walk for an hour a day. Also, I take my medicine, because the doctor knows best."

A version of this article appeared in the print edition of The Straits Times on May 31, 2016, with the headline 'Medication, not ethnicity, controls cholesterol levels'. Print Edition | Subscribe