Cardiovascular Disease
Cardiovascular disease which comprises coronary heart disease and stroke causes one third of all deaths worldwide. Cardiovascular disease is the leading cause of death among Singaporeans accounting for 32.8% of the total deaths in Singapore.* It is also the number one killer disease for women.
* Source: Ministry of Health 2005

What is Coronary Heart Disease
Coronary heart disease is a condition in which there is not enough blood getting to the heart muscles and therefore the heart is unable to pump blood properly to all parts of the body. High levels of fat and cholesterol cause blockages in the arteries that supply the blood to the heart. If the coronary arteries become too narrow or become blocked entirely, it can cause a heart attack, heart failure or even cardiac arrest.

Know the Risk Factors for Coronary Heart Disease
To determine your risk of developing coronary heart disease, doctors often evaluate ‘risk factors’. The more risk factors one has, the higher the chances of developing coronary heart disease. Here are some of the main risk factors*:

1. A family history of heart disease
You and your family may be at increased risk of a heart attack if your close or immediate relatives have a history of heart disease.

2. High blood pressure
High blood pressure makes the heart work harder, causing it to enlarge and weaken over time. If not properly managed, high blood pressure may result in heart attack, heart failure or other serious conditions such as kidney failure or stroke.

3. High blood cholesterol
The risk of heart disease rises as the cholesterol level increases. It is important to know one’s own cholesterol level so that action can be taken and in high-risk cases, patients can be treated and closely monitored by their family physicians. Do you have high blood cholesterol? Does it run in your family?

4. Diabetes
Diabetes is a disease in which the body does not make or respond to the insulin hormone, which is needed to convert sugar into energy or into other food for storage. Persons with diabetes have two to three times greater risk of heart attacks if their condition is not kept under control. A family history of diabetes poses you at greater risk of developing diabetes in later life.

5. Smoking
Smokers beware! If anyone in your family smokes, they are three times more likely to get a heart attack. The poison in cigarette smoke damage arteries, speed atherosclerosis and deprive the heart of oxygen.

6. Other main risk factors include
Excess body weight
Lack of regular exercise
Prolonged and excessive mental stress
Excessive alcohol consumption

* It is important to note that the risk factors for coronary heart disease and stroke are the same.

Metabolic Syndrome - The Time Bomb
Recently, doctors have been increasingly worried about the presence of ‘metabolic syndrome’ in their patients. The metabolic syndrome is described as a group of several risk factors in one person. If the patient has three or more of these risk factors, he or she is at high-risk of developing diabetes or coronary heart disease.

	Central obesity as measured by waist circumference. Greater than 80 centimeters (if you are a woman) or more than 90 centimeters (if you are a man)
	Fasting blood triglycerides greater or equal to 150mg/dL
	Blood HDL cholesterol less than 50 mg/dL (if you are a woman) or less than 40 mg/dL (if you are a man)
	Blood pressure greater than or equal to 130/85 mmHg
	Fasting glucose greater than or equal to 110mg/dL

Discomfort in other areas of the upper body: Symptoms can include pain or discomfort in one or both arms, the back, the neck, jaw or stomach.

Shortness of breath: This feeling often comes along with chest discomfort. But it may occur before the chest discomfort.

Other signs: These may include breaking out in cold sweat, nausea, or light-headedness.

Know the Warning Signs of Stroke

	Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
	Sudden confusion, trouble speaking or understanding.
	Sudden trouble seeing in one or both eyes.
	Sudden trouble walking, dizziness, loss of balance or coordination.
	Sudden, severe headache with no known cause.

Not all of these warning signs occur with every heart attack or stroke. If you have one or more of these signs, don’t wait longer than five minutes before calling for help.

Heart Attack and Stroke are Medical Emergencies. Call 995 and get to the hospital right away.



Ask your doctor about:
Blood Pressure
Body Mass Index (BMI)
Cholesterol
Blood glucose (blood sugar)

Classification of Total, LDL and HDL Cholesterol and Triglyceride Levels

HDL = High-density lipoprotein ; LDL = Low-density lipoprotein

Definitions and classification of BP levels for adults aged 18 years and older

Isolated systolic hypertension is graded to the same level of systolic BP.
Source: MOH Clinical Practice Guidelines 2/2005