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Sunday is World Heart Day. One in three deaths here is a result of cardiac illness and the number of young as well as older people hit is rising. Doctors tell MYB that prevention is key to stemming the onslaught of the disease
Newer and better types of medicine, surgical techniques and devices like pacemakers are part of the continuing fight against heart disease.
Central to winning this battle, however, are the precautions which need to be taken – so that the need for these interventions can be avoided. “Prevention is still the best way to fight coronary artery disease and heart failure,” said Associate Professor Tan Huay Cheem, director of the National University Heart Centre.
Heart disease, the second biggest killer in Singapore, is responsible for one in three deaths here, based on data from the Ministry of Health. Heart disease includes coronary artery disease, ischaemic heart disease (where heart muscles do not receive enough blood) and heart failure.
Added Prof Tan: “Heart failure is the next wave of epidemic as there is a rising number of such patients, mainly because of an ageing population.
“In Singapore, there are about 5,000 hospitalisations for heart failure every year, which is a tremendous social and financial cost to our society.”
And the young are not spared. Dr Felix Keng, senior consultant cardiologist at the National Heart Centre Singapore (NHCS), said that the centre is seeing more young people.
Based on personal observation, the number of patients aged 40 and below has doubled from five years ago.
“Heart patients are not only increasing but they are also getting younger and younger, which is worrying,” said Dr Keng, who is also the director of nuclear cardiology.
That is why NHCS recently renovated its top floor to make room for more patients.
The changes, completed in March, include a room dedicated to heart health screening.
Dr Keng said that the centre has been allocating more funds and space for heart screening in the past five years.
After all, screening is one of the key preventive measures. In general, people over 35 years old should get screened.
However, those with risk factors should go for heart screening even earlier.
Risk factors for heart disease include a family history of heart disease, diabetes, high blood pressure and cholesterol, as well as lifestyle habits like smoking and alcohol consumption.
Based on individual choice and the doctor’s assessment, one may need to undergo a specific combination of screening methods.
Heart screening packages are available at NHCS and hospitals like Changi General Hospital and Raffles Hospital, with prices ranging from $120 to $1,500.
Currently, there are numerous imaging methods on top of the conventional blood test and treadmill test that assess the heart’s response to exercise.
They include chest X-rays, myocardial perfusion scans that show the function of heart muscles and two-dimensional echocardiogram (ultrasound of the heart).
The latest addition is the use of computed tomography (CT) technology. Such scans were accepted as a form of cardiac testing only about five years ago, said Dr Keng. Doctors are able to view the entire heart in 3-D and the condition of the arteries and valves in a CT angiogram. Our cover photo shows the image of such an angiogram.
All these imaging tools mean that doctors now have different sets of information with which they can better assess heart health, added Dr Tan.
Prevention also continues at home. A healthy diet, regular exercise and stress management can contribute to better heart health, said consultant cardiologist V. P. Nair, who runs a private practice at Mount Elizabeth Medical Centre.
Dr Nair recommends regular aerobic exercises such as brisk walking and swimming daily, with each session lasting 30 minutes to an hour.
When preparing meals, remove all visible fat from meat as they contain bad cholesterol that can clog arteries.
In addition, use healthier cooking methods like baking instead of frying.
Such measures are especially vital for working adults for they are at greater risk of heart disease than before, said Dr Nair.
For one thing, they may be under more stress. Some may have to work longer hours to cope with the rising cost of living, he said.
Many also opt for unhealthy but convenient fast-food meals.
They may also choose to walk less due to the time crunch. Instead, they would drive from one place to another and rely on escalators and lifts, he added.
“The new generation of working adults must therefore strive to adopt prudent eating habits, exercise regularly, cut out smoking and go for regular check-ups,” he said, adding that stress levels can be kept in check through counselling, spending time with family and friends and meditation.
Agreeing, Dr Tan added: “Treatment is expensive but prevention is not as bad – you simply eat less and walk more.”
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