Cardiovascular disease is one of the leading causes of death in Singapore, with about 1 out of 3 deaths in 2023 due to heart disease or stroke. But the good news is that many heart problems can be prevented or managed through early detection, healthy lifestyle choices, and timely medical interventions.
Cardiac risk refers to the likelihood of developing heart disease or events, such as a heart attack or stroke. By focusing on primary prevention, early detection, and effective intervention, we can significantly reduce our risk of heart problems and live healthier, longer lives.
1. Primary Prevention: Reducing Risk Before It Starts
The best way to protect your heart is to reduce risk factors before heart–related problems develop. In our previous article on Understanding Cardiac Risk, we discussed conditions like insulin resistance, obesity, high cholesterol, and kidney dysfunction, which can increase cardiac risk. Managing these factors can significantly lower the overall risk of heart disease.
Primary prevention focuses on making healthy lifestyle choices, start adopting the Life’s Essential 8 by AHA:
Eat Better:
Adopt a diet low in unhealthy fats, salt, and sugar. Limit processed foods high in added sugars, salt, and trans fats, which raise LDL (bad cholesterol) and increase heart disease risk. Focus on whole foods like fruits, vegetables, whole grains, lean proteins, and legumes.
Examples of heart-healthy diets include:
- Mediterranean Diet: Emphasises fruits, vegetables, whole grains, legumes, lean proteins (especially fish), and healthy fats like olive oil.
- DASH Diet: Focuses on lowering sodium and increasing potassium, calcium, and magnesium-rich foods to manage blood pressure.
- Plant-Based Diet: Rich in fruits, vegetables, nuts, seeds, and legumes, while minimising animal products to lower cholesterol and reduce heart disease risk.
Be More Active:
Physical activity helps improve heart health by lowering blood pressure, reducing cholesterol, and maintaining a healthy weight. Aim for at least 150 minutes of moderate intensity exercise each week, such as walking, swimming, or cycling.
“Moderate intensity” means you can hold a conversation in short or half sentences, but not sing a song during the activity.
Quit Smoking:
Smoking damages blood vessels, raises blood pressure, and reduces oxygen in the blood, which increases the risk of heart disease.
Maintain a Healthy Weight:
By maintaining a healthy weight through diet and exercise, you can reduce your risk of developing high blood pressure, high cholesterol, and diabetes—all of which contribute to heart disease. The healthy BMI range is between 18.5 and 22.9 kg/m², according to the WHO guidelines.
Limit Alcohol Consumption:
Excessive alcohol can raise blood pressure and contribute to heart disease. Based on the HPB guidelines, no more than 2 standard drinks per day for men and no more than 1 standard drink per day for women.
A standard alcoholic drink is defined as a can (330 ml) of regular beer, half a glass (100 ml) of wine or 1 nip (30 ml) of spirit – in accordance to healthhub.
2. Early Detection: Catching Problems Before They Become Serious
Early detection of heart disease is essential because it allows for prompt action before problems become life-threatening. Even without symptoms, regular screenings can help identify hidden risks.
Some of the traditional and non-traditional screening methods are available to assess heart health:
| Traditional Screening Methods (Identify common risk factors) | Non-Traditional Screening Methods (Provides additional insights) |
|---|---|
|
Blood Pressure Checks: |
Lipoprotein(a) [Lp(a)] Test: |
|
Lipid Panel (Cholesterol Test): |
Apolipoprotein B (apoB) Test: |
|
Blood Sugar Testing: |
Urinary Albumin-to-Creatinine Ratio (uACR): |
|
Body Mass Index (BMI) Measurement: |
Coronary Artery Calcium (CAC) Scoring: |
3. Intervention: Addressing Heart Disease Once It’s Detected
If you’ve been diagnosed with risk factors for heart disease or have already developed a cardiovascular condition, timely intervention is critical to prevent complications. Interventions can include:
- Lifestyle Changes: Adopting a healthy diet, exercising, and quitting smoking can significantly improve heart health and reduce the need for invasive treatments.
- Medications: Help manage conditions like high blood pressure, high cholesterol, or diabetes.
- Medical Procedures: In more severe cases, procedures such as coronary angioplasty (to open blocked arteries) or bypass surgery may be needed to restore blood flow.
The Role of Healthcare Providers: Who Should We Find?
Managing cardiac risk is a team effort between you and your healthcare providers. Both general practitioners (GPs) and cardiologists play important roles in assessing and managing heart health.
- General Practitioners (GPs): Your GP is often the first point of contact for heart health. They conduct routine screenings, assess your risk factors, and manage conditions like high blood pressure, cholesterol, or diabetes. If needed, they’ll refer you to a cardiologist for specialised care.
- Cardiologists: Cardiologists specialise in diagnosing and treating complex heart conditions. They perform advanced tests (like stress tests or echocardiograms) and may recommend procedures such as angioplasty. Cardiologists work closely with GPs to ensure you receive the most appropriate care.
Conclusion
Heart disease doesn’t have to be inevitable. By focusing on primary prevention through healthy lifestyle choices, early detection through regular screenings, and timely interventions when necessary, we can significantly reduce the risk of heart disease. With the right support from healthcare providers—both GPs and cardiologists—we can manage and prevent heart disease more effectively. Regular check-ups and understanding your risk factors are key steps in protecting your heart for the long term.
If you have any concerns about your heart health or wish to improve and manage it, our cardiologists at Nobel Heart Centre are here to help.
