Elderly exercising to keep their heart healthy

Did you know that in Singapore, 17 people die from heart disease and stroke everyday, making cardiovascular disease the 2nd most common cause of death here? The scary thing about cardiovascular disease is it can strike unexpectedly regardless of age or size — I’m sure you’ve heard of the many marathon runners who collapsed and passed on suddenly due to a heart attack.

The good news is as with other forms of life-threatening conditions, cardiovascular disease can be prevented if detected early. One such way of detection is through a cardiac screening, where you find out your risk factors through your body mass index (BMI), blood pressure, cholesterol and glucose levels.

What is heart disease?

The term ‘heart disease’ is actually an umbrella term for many types of cardiovascular-related conditions. While they may have different symptoms and onset in different ways, these diseases have one thing in common: they affect how your heart functions.

The most common types of heart disease in Singapore include:

Coronary Artery Disease

Coronary artery disease, or ischemic heart disease, is the result of plaque buildup in the arteries. Smoking, high blood pressure and diabetes are some of the leading risk factors for coronary artery disease. Most people do not get symptoms till much later, which include chest pain (angina), dizziness and fainting.

Atherosclerosis

Atherosclerosis is the hardening and narrowing of your arteries, leading to conditions like coronary heart disease, carotid artery disease and stroke.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle that makes it hard for your heart to pump blood to the rest of your body, leading to heart failure.

Arrhythmia

Arrhythmia is a problem with your heart rate, meaning your heart beats too quickly, too slowly, or at an irregular pattern. Often there are no symptoms, but you might feel faint or have difficulty breathing. In Singapore, common triggers for an arrhythmia include alcohol, tobacco and stress.

Congenital heart defects

You may have heard of the term ‘hole in the heart’ — what this means is the patient has a heart defect present since birth that can cause difficulty breathing, high blood pressure and heart failure.

What are the early warning signs of heart disease? Who can get it?

Many patients think that only the elderly and obese suffer from heart diseases. While it is true that these two groups are most at risk, you’d be surprised to know I see many younger patients who supposedly look fit too. The reality is anyone can get cardiovascular diseases including those on medication for pre-existing conditions unrelated to the cardiovascular system.

These are things we can’t control, but what we can definitely control is our lifestyle, diet and going for regular cardiac screenings. I highly recommend that you see a specialist for a cardiac screening or heart screening if you frequently experience the following symptoms:

  • Chest pain and discomfort
  • Dizziness
  • Fatigue
  • Nausea
  • Low tolerance towards exercise

cardiac screening monitor showing ECG pulse and blood pressure reading

What does cardiac screening involve?

Cardiac screenings involve more than just hooking you up to a beeping machine and checking your heart rate. They are a lot more holistic than you think.

I usually start with asking some questions to understand your personal and family health history. This is to determine your risk profile. For example, do you smoke or drink? How often do you engage in physical activity? These are some factors that can give me a rough gauge on your heart health. Next, I may carry out non-invasive ECG tests to record your heart activity such as a 2D echocardiogram and treadmill tests.

Lastly, arguably the most important, is screening you for conditions associated with heart disease including high cholesterol, diabetes and hypertension. Detecting and monitoring these conditions is crucial in reducing the onset and progression of heart disease.

How often should I do cardiac screenings?

In Singapore, cardiac screenings should begin from the age of 18, though it is especially important for men above 40 and women above 50 to be screened regularly. If you smoke, frequently drink alcohol or have diabetes, high cholesterol or high blood pressure, cardiac screenings will benefit you.

Below, a table of the different forms of cardiac screenings I recommend and how often you should get them done.

Recommended screeningsFrequency
Blood pressureAt each healthcare visit or at least
once a year if your blood pressure
is less than 120/80 mm Hg
Cholesterol (total cholesterol,
cholesterol HDL, cholesterol LDL,
triglycerides)
Every 4-6 years if you are at no risk
or normal risk
Weight and BMIDuring your regular healthcare visit
Diabetes/blood glucose testEvery 3 years if you have no risk

 

Taking time to do screenings might seem like a hassle, but a simple test could save your life!

References

  1. Attia, Z. I., Kapa, S., Lopez-Jimenez, F., McKie, P. M., Ladewig, D. J., Satam, G., Pellikka, P. A., Enriquez-Sarano, M., Noseworthy, P. A., Munger, T. M., Asirvatham, S. J., Scott, C. G., Carter, R. E., & Friedman, P. A. (2019). Screening for cardiac contractile dysfunction using an artificial intelligence-enabled electrocardiogram. Nature medicine, 25(1), 70–74. https://doi.org/10.1038/s41591-018-0240-2
  2. Escobar E. (2002). Hypertension and coronary heart disease. Journal of human hypertension, 16 Suppl 1, S61–S63. https://doi.org/10.1038/sj.jhh.1001345