PETALING JAYA: While the repeated movement control orders have not dented James Sundram’s cheery optimism, the recent loss of three fellow taxi drivers – all of whom he said died due to stress-related heart attacks – is certainly enough to shed a few tears.
With tourists non-existent since last year, and various movement restrictions and bans on non-essential businesses meaning more people have been staying at home during the Covid-19 pandemic, it has been a constant struggle for taxi drivers like Sundram to make ends meet.
“They were really stressed. They kept getting calls from banks, landlords and taxi leasing companies. Eventually, they had heart attacks and passed away,” said the 57-year-old of his deceased colleagues.
“I don’t know if they had any underlying illnesses, but most of the taxi drivers I know have diabetes and hypertension.
“This year has been extremely difficult for us. There are no customers, and many taxi drivers are stressed out.”
When FMT met him at 1pm at a shopping mall here, Sundram had yet to get a single passenger despite waiting since 8am.
However, the taxi driver’s theory behind how lockdown stress could have led to his friends’ deaths is not too far-fetched.
Heart attacks have been the country’s number one killer for the past 15 years, and it took 16,325 Malaysian lives in 2019 – roughly 45 people a day.
Even during pre-pandemic times, a 2017 report in The Lancet, one of the world’s oldest and most respected medical journals, pointed out that emotional stress is associated with increased risk of cardiovascular disease.
Last year, a study of 1,914 patients published in the American Medical Association journal suggested that psychological, social and economic stress related to the Covid-19 pandemic was associated with an increased incidence of stress cardiomyopathy, or a stress-induced heart attack.

A consultant cardiologist at the iHEAL Medical Centre in Kuala Lumpur, Dr Wong Teck Wee, noted that people who are under long periods of stress are more likely to lead a sedentary lifestyle and engage in harmful habits such as smoking, overeating and excessive alcohol consumption, all of which are linked to increased risk of heart disease.
“When you have a lot of chronic stress, you will lead a very unhealthy lifestyle,” he said.
“And after one-and-a-half years of the MCO, there is chronic stress among many Malaysians as the long-term lockdowns are straining them financially.
“Stress affects sleep, and if you don’t sleep well, there could be other issues related to this, mainly increased blood pressure and heart rate.
“This may put extra strain on your heart and can trigger a heart attack if you have a blockage,” he said, adding that the taxi drivers might have had pre-existing conditions which led to their heart attacks.

Wong also said studies suggest that chronic stress can increase blood pressure, cholesterol and sugar levels, all of which are common risk factors for heart disease.
Dr Azmee Mohd Ghazi, a consultant cardiologist at the National Heart Institute (IJN), agreed that the taxi drivers might have had underlying health issues which contributed to the heart attacks.
Noting how some patients put off their appointments or stopped taking their medication during the pandemic, Azmee said he has observed a trend of patients now returning for their check-ups with worse readings than before.
“Their cholesterol is bad, their sugar is bad, and their hypertension is not well controlled. All of this will increase the risk of heart attacks,” he said.
He also warned that people who had no health conditions might be at risk of developing heart diseases in the years to come if chronic stress continues to be a problem.
“These are trends that will increase, maybe not right now, but in another three or four years down the road,” he said.
FMT has reached out to the health ministry for information on lockdown-related stress and heart attacks.