Okay so last month I had this patient walk into my clinic. Let’s call him Rizal. 44, works in some finance job near Bangsar South, drives in from Rawang every day. RAWANG. That’s like what, an hour and a half each way on a good day? Two hours when it rains?
Anyway, Rizal comes in looking tired. Not sick-tired. Just… life-tired. You know the look. We all know the look.
“Doc, my chest feels weird sometimes,” he tells me. “Like tight. Usually in the morning jam. But it goes away, so I figured it’s just stress.”
Just stress. Famous last words, honestly.
So I check his blood pressure. 158 over 96. Not great. Check his cholesterol from the blood test – LDL through the roof, HDL too low. Fasting glucose creeping into prediabetes territory. The man is 44 and his body is running like it’s 60.
And the thing is? Rizal isn’t some outlier. He’s not unusual. He’s NORMAL. He’s the same as half the working adults in the Klang Valley – grinding themselves down, assuming their body will just figure it out somehow.
Your body doesn’t “figure it out.” Your heart especially doesn’t figure it out. It just keeps score until one day, the bill comes due.
So let’s talk about this. Because if you’re reading this while sitting in traffic or pretending to pay attention in a meeting, you might be Rizal too.
What Stress Is Actually Doing To Your Heart (It's Not Pretty)
Here’s the thing people don’t get about stress. It’s not just a feeling. It’s not just “in your head.” Chronic stress causes actual, measurable, physical damage to your cardiovascular system.
Let me explain this in normal human language.
Your stress hormones are going crazy. Cortisol – that’s the big stress hormone – is supposed to spike during emergencies and then go back down. Fight or flight, right? Problem is, your body can’t tell the difference between a tiger attack and two hours of traffic followed by ten hours of work pressure. So cortisol stays high. All the time. For years. And high cortisol does nasty things – raises your blood pressure, messes with your blood sugar, makes you store fat around your belly, causes inflammation everywhere. None of this is good for your heart.
Your blood pressure is running too high. When you’re stressed, your blood vessels tighten and your heart beats faster. That’s normal if it’s temporary. But when it’s happening for hours every single day? Your body basically recalibrates to run at higher pressure permanently. That’s hypertension. That’s a major risk factor for heart attacks and strokes.
Inflammation is wrecking your arteries from the inside. This one’s sneaky. Chronic stress causes inflammation throughout your body. Inflammation damages the walls of your blood vessels. Damaged walls are where plaque builds up. So when people say “nasi lemak causes heart disease” – yes, diet matters, but it’s not the whole picture. Stress is making your body MORE VULNERABLE to damage from bad diet. It’s a team effort of self-destruction.
Your heart rhythm gets weird. Ever felt your heart flutter or skip beats when you’re stressed? That’s stress hormones directly messing with your heart’s electrical system. Usually harmless. Sometimes not. If it’s happening a lot, especially with dizziness or chest discomfort, that needs checking.
And then there’s all the coping mechanisms. Stressed people eat worse, exercise less, sleep terribly, drink more, and some smoke. These behaviors pile on top of the direct physical effects of stress. It’s a vicious cycle and your heart is caught in the middle of it.
Your body was designed to handle stress in short bursts. Tiger appears, you run, tiger goes away, you calm down. It was NOT designed for being in low-grade fight-or-flight mode for basically your entire waking life.
Your Commute Is Slowly Killing You (I Wish I Was Exaggerating)
Look, I’m not being dramatic for effect here. There’s actual research on this. Multiple studies, different countries, consistent findings: people with long commutes have significantly higher rates of cardiovascular disease, hypertension, obesity, diabetes, anxiety, and depression.
And the average KL commuter? Two to three hours a day in traffic. Do the math. That’s ten to fifteen hours a week. Forty to sixty hours a month. Five hundred plus hours a year. Sitting in a metal box, breathing exhaust fumes, stressed out of your mind, not moving, not exercising, not sleeping, not doing anything good for yourself.
Why is this so bad for your heart specifically?
- Sitting is terrible for you. Like, independently-linked-to-heart-disease terrible. Your circulation slows, your blood pressure goes up, your metabolism tanks. Sitting in your car for hours is basically poisoning yourself slowly.
- Traffic stress hits different. There’s something uniquely horrible about being trapped, unable to control anything, surrounded by aggressive drivers and bad decisions. Studies have measured this – cortisol and blood pressure spike hard during traffic jams. It’s not just annoying; it’s physiologically damaging.
- You’re breathing garbage. Air pollution directly damages blood vessels and increases cardiovascular risk. Sitting in traffic means breathing concentrated exhaust fumes for hours. Your aircon filter can only do so much.
- It steals time from everything healthy. Every hour in traffic is an hour you’re NOT exercising, cooking proper food, sleeping, or doing anything good for your body. The opportunity cost is massive.
- Sleep deprivation adds up. Long commute = wake up earlier + get home later = less sleep. Most people I see are running on five or six hours when they need seven or eight. Chronic sleep loss is a huge cardiovascular risk factor.
You might think “well, I’ve been doing this for years and I’m fine.” But here’s the thing – damage accumulates silently. You feel fine until suddenly you don’t. That’s how heart disease works.
Warning Signs You're Probably Ignoring (Please Stop Ignoring Them)
Your heart doesn’t just quit one random day. It sends signals. The problem is most people either ignore them, rationalize them away, or genuinely don’t recognize them as heart-related.
So let me be very clear about what you should be watching for:
Chest discomfort. And I don’t mean dramatic Hollywood heart attack clutching. Could be tightness. Pressure. Squeezing. Heaviness. A weird feeling you can’t quite describe. Might come and go. Might happen during stress or exercise or for no apparent reason. If you’re having recurring chest symptoms of ANY kind – get it checked. Don’t convince yourself it’s “just gas” or “just stress.”
Getting breathless easier than before. Climbing stairs used to be nothing, now you’re huffing at the top? Can’t walk as fast or as far? This could mean your heart isn’t pumping as well as it should.
Weird tiredness. Not normal “I didn’t sleep well” tired. I mean unusual, unexplained exhaustion. Feeling wrecked by activities that used to be easy. This is especially common in women and often gets dismissed. Don’t dismiss it.
Heart doing funny things. Racing for no reason. Fluttering. Skipping beats. Pounding. Occasional palpitations are usually nothing. But frequent ones, or palpitations plus dizziness or chest discomfort? Needs evaluation.
Dizzy spells. Feeling lightheaded when you stand up, during exercise, or randomly. Could be blood pressure issues. Could be heart rhythm problems. Either way, don’t ignore it.
Swollen feet and ankles. When your heart isn’t pumping effectively, fluid builds up. If your shoes suddenly feel tight or you’re seeing puffiness that leaves an indent when you press it – that’s a red flag.
Pain spreading to arm, jaw, neck, or back. Especially with chest symptoms. Classic cardiac territory. I’ve had patients tell me they thought jaw pain was a tooth problem. It wasn’t.
Random cold sweats. Breaking into a sweat for no reason when you’re not hot and not exercising? Combined with other symptoms, this can signal your heart is in distress.
Look, I know you’re busy. I know you don’t want to think about this stuff. But please don’t wait for dramatic symptoms before taking your heart seriously. Heart attacks can be subtle. People – especially women – often have vague or atypical symptoms. “I thought it was just indigestion” is a sentence I’ve heard way too many times.
When You Actually Need To See A Doctor (Spoiler: Probably Now)
I already know what you’re thinking. “I’ll go when I have time.” “I’ll go if it gets worse.” “I’ll go after this project finishes.”
No you won’t. You’ve been telling yourself that for how long now?
Heart disease doesn’t care about your calendar. It doesn’t wait for a convenient time. And by the time symptoms become impossible to ignore, you’ve often got a much bigger problem than you would’ve had if you’d just gotten checked earlier.
Make an appointment soon if:
- You’re over 35 and can’t remember your last heart check (most of you)
- Heart attacks, strokes, or heart disease run in your family
- You’ve noticed any of the warning signs I mentioned
- Your stress levels have been consistently high for months/years
- You’ve gained weight and your fitness has obviously declined
- You smoke or you quit recently
- You already know you have high BP, high cholesterol, or diabetes
- You’re just curious where you stand (this is a valid reason, by the way)
Go to emergency NOW if:
- Chest pain or pressure that doesn’t go away after a few minutes
- Chest symptoms PLUS shortness of breath, sweating, nausea, or feeling faint
- Pain spreading to your arm, jaw, or neck with chest discomfort
- Sudden severe difficulty breathing
- You faint or almost faint
- Racing or irregular heartbeat with dizziness or chest pain
One more thing: I’ve seen heart attacks in people in their thirties. Don’t assume you’re too young. If something feels really wrong, it probably is. Trust your gut.
Realistic Things You Can Actually Do (Not Useless Advice)
I hate health articles that are like “just reduce your stress!” and “exercise for 30 minutes every day!” and “eat healthy balanced meals!” Like… okay. With what time? What energy? What magical alternate reality where my boss doesn’t demand things at 6pm?
I’m not going to insult you with that nonsense. Here’s stuff you might actually be able to do:
Steal movement wherever possible. You don’t need a gym. Park further from the entrance. Take stairs for one or two floors. Stand up during phone calls. Walk around when you’re thinking. Take a short walk after lunch instead of scrolling. Ten minutes here and there adds up. Your heart doesn’t care WHERE movement comes from, just that it happens.
Make your commute less toxic mentally. You can’t fix the traffic. But you can change how you experience it. Good podcasts, audiobooks, music that actually calms you instead of riling you up. Some people do breathing exercises at red lights. Sounds weird, actually helps. The goal is to make your commute feel less like psychological torture.
Upgrade your food even slightly. I’m not asking you to meal prep like some fitness influencer. Just… less terrible choices. Swap teh tarik for teh O kosong sometimes. Get the grilled instead of fried occasionally. Add some vegetables to your life. Skip the second portion of rice. Small changes, less damage.
Sleep is not negotiable. I mean it. Seven hours minimum. Your heart literally repairs itself while you sleep. You’re not being productive by sleeping less – you’re just deteriorating faster. Put the phone down at night. This one matters more than people realize.
Notice when you’re spiraling. Everyone has stress warning signs. For some it’s irritability. For others it’s headaches, stomach issues, insomnia, neck tension. Learn yours. When you notice them, do SOMETHING – even five minutes of walking, even just stepping outside. Breaking the spiral early makes a difference.
It’s okay to talk to someone. Burnout is real. Chronic stress is a medical issue. If you’re struggling to cope, a counselor or therapist isn’t weakness – it’s maintenance. You service your car right? Same concept.
Know your numbers. Blood pressure. Cholesterol. Blood sugar. These numbers matter and you can’t manage what you don’t know. Annual check-ups should be non-negotiable if you live this lifestyle.
Come Find Out Where You Actually Stand (Dr Prevents)
Here’s my ask. Simple ask. Don’t wait until something goes wrong. Come find out where you actually stand while there’s still time to do something about it.
At Dr Prevents, I see people like Rizal constantly. Stressed. Busy. Vaguely worried. Hoping everything’s fine but also kind of scared to find out. I get it. Really.
We’ll work with your schedule. We won’t waste your time. And I’ll give you straight answers – no sugarcoating, but no unnecessary panic either.
What we do:
- Proper cardiovascular screening – blood pressure, full cholesterol panel, blood sugar, BMI, the works
- ECG – checks your heart’s electrical activity, takes five minutes, tells us a lot
- Actual risk assessment – not vague “be careful” advice, but real calculation based on YOUR numbers
- Honest conversation – I’ll tell you what’s going on and what you can do about it
- Realistic recommendations – for your actual life, not some fantasy life where you have unlimited time
- Follow-up – we track your progress and adjust as needed
- Specialist referral if needed – if we find something that needs a cardiologist, I’ll connect you
Rizal? He’s doing okay now. On medication for his BP and cholesterol. Made some changes – not dramatic ones, just small stuff that added up. Still drives from Rawang, still works long hours. But now he knows his numbers and he’s actually managing them instead of just hoping for the best.
That’s the difference between a wake-up call you can learn from and a tragedy you can’t come back from.
30 Minutes Could Add Years To Your Life. Literally.
Your Heart Doesn't Care About Your Excuses. Neither Does Reality.
I want to leave you with this.
The Klang Valley lifestyle is hard on your body. The commutes, the stress, the sitting, the bad food, the terrible sleep – it’s brutal. And I’m not saying that to judge you. I live here too. I get it.
But your heart doesn’t understand traffic. It doesn’t know about deadlines and office politics and cost of living. It doesn’t care that you’re busy. It just keeps pumping, taking damage, accumulating wear and tear, day after day after day.
Until one day it can’t anymore.
You probably can’t quit your job next week. Can’t teleport past traffic. Can’t make stress disappear. I know that.
But you CAN:
- Be honest with yourself about the cardiovascular risk you’re carrying
- Make small changes where you can – they compound over time
- Stop ignoring warning signs and rationalizing them away
- Actually find out your numbers instead of guessing
- Get checked regularly instead of waiting for crisis mode
Your heart has been beating for you since before you were born. A hundred thousand times a day, every day, without complaint. Maybe – just maybe – it’s time to start paying attention to it.
Don’t wait for a wake-up call. Some wake-up calls you don’t get to wake up from.
Take care of yourself. Please.