Heart Screening: Know Your Cardiovascular Risk

We all know that the heart is a vital part of our body and heart disease is a serious health concern. However, many of us do not know how healthy our hearts are. One of the reasons is that heart health manifests through ‘silent’ indicators that we cannot easily feel, such as blood pressure, blood cholesterol levels or heart rhythm. We need medical professionals to tell us. The good news is the risks for common cardiovascular diseases such as coronary heart disease, heart attack, or stroke can be detected and managed early by conducting regular health checks for the heart.

In this article, we will discuss what a heart health check is, why it is important, who should have their heart health screened, and what a heart screening typically entails. Read on for tips to manage your risk and prevent cardiovascular incidents, especially for individuals with higher cardiovascular risks such as those with high blood pressure, high cholesterol, diabetes,  sleep apnea or mental health.

1. What is a Heart Health Check?

A heart health check, also known as a heart screening, or cardiovascular screening, is a medical assessment of how healthy the heart and cardiovascular system generally is. A doctor will conduct a physical examination, order tests, and ask questions about the patient’s lifestyle and medical history to assess their risk of heart disease. The objective is to catch the early signs of heart disease among people who feel and look healthy. If risk is detected, actions can be taken to lower the chance of developing a cardiovascular event.

Similar to a general health check, a heart screening or cardiovascular screening can be done at a GP clinic, or hospital. However, if patients experienced cardiac events in the past, it is recommended to have the cardiovascular screening supervised by a Cardiologist who is familiar with their conditions.

2. Why is a Heart Health Check Important? 

Cardiovascular disease is the leading cause of death and disease burden in Singapore. Survivors from major cardiovascular events such as a heart attack, or a stroke may face disability or other irreversible side effects to the body, not to mention the mental distress. The saying “Prevention is better than cure” rings true to cardiovascular disease. Heart screening is one of the most effective and accessible tools available today in preventing cardiovascular diseases.

Furthermore, many of the risk factors for heart and other cardiovascular disease are modifiable. In other words, changes in lifestyle and exposure can help lower the risk, thereby preventing cardiovascular disease from happening. Modifiable risk factors of cardiovascular disease include smoking, being overweight, an inactive lifestyle, high blood pressure (or hypertension), high cholesterol (or hyperlipidaemia), and high blood sugar (or hyperglycemia). Find out more about common heart diseases in Singapore and check your risk factors from our article here.

Another reason for the necessity of a heart screening is the ‘silent’ nature of cardiovascular risk factors. Risk factors such as high blood pressure and high cholesterol don’t cause pain or discomfort for a long time, often until they have led to complications. In Singapore, half of those with high blood pressure are not aware of their conditions. Sometimes, minor heart attacks can also happen silently. Without the assessment by a medical professional, many may miss the chance to protect themselves from serious cardiovascular disease.

3. Who Should Get a Heart Health Check?

In Singapore, everyone above the age of 40 is recommended to go for a heart health check at least once every 3 years, unless advised otherwise by their doctor. Others with risk factors such as family or personal history of cardiac events, or comorbidity such as diabetes or kidney patients, can start screening earlier.

4. What to Expect at a Heart Health Check?

Except for patients with high risk or existing cardiovascular conditions who often go through more elaborate screening tests, below are the typical steps involved in a regular heart screening.

  • Blood pressure measurement 
  • Blood tests to find out blood cholesterol and blood sugar levels
  • Electrocardiogram (ECG) to check the heart's rhythm and electrical activity
  • Physical examination, such as weight, height measurement, listening to your heart rhythm, etc
  • Answer questionnaires or discuss with your doctor about medical history and lifestyle
  • Doctor’s assessment of your risk level 
  • Advice on risk management actions based on the risk assessment result

Risk level is commonly calculated as the probability of experiencing a cardiovascular event over the next 10 years. Low-risk individuals have less than 10% risk, while intermediate-risk individuals have between 10%-20% risk, and high-risk patients have the risk score of 20% and above. 

5. How to Lower the Risk of Cardiovascular Disease?

Lifestyle changes are the most commonly recommended measures to control cardiovascular risks. Medications may be given, for example to control blood pressure, high cholesterol or blood sugar. In some cases, patients may be referred to a Cardiologist or other relevant specialist for a more comprehensive examination. 

For everyone, including those with low risk levels for heart disease, it is important to understand what can affect your cardiovascular risks and actively manage it. Below is a list of common risk factors for cardiovascular diseases and what you should do about it, listed in 3 big groups: lifestyle factors, medical factors and factors that are out of your control such as age, gender, or family history. 

Understanding these risk factors will help you have a more meaningful discussion with your doctor during the heart screening, as well as take active steps to cut your risks.

5.1. Control Lifestyle Risk Factors of Cardiovascular Disease: 

The lifestyle choices we make everyday have an impact on our overall health. The impact is so gradual that we often overlook it. Yet, if left uncontrolled, it can accumulate and wreak havoc on our cardiovascular health. The good news is, since they are lifestyle factors, we have the power to make changes and take control of our heart health. 

Below are major lifestyle changes that can positively affect our cardiovascular health.

  • Quitting Smoking

Smoking has been proven to increase the risks of cardiovascular diseases. With all other factors equal, smokers are twice more likely than non-smokers to develop serious cardiovascular conditions such as heart failure, stroke, and acute myocardial infarction (sudden blockage of the coronary artery). Additionally, smokers also put their family members and social circle who do not smoke, at risk. 

Smokers who quit often see improvements in cardiovascular health risk factors such as blood pressure after giving up smoking. Similarly, quitting smoking can have a positive effect on the heart health of your loved one as well. 

  • Maintaining a healthy diet 

An unhealthy diet increases the risk of weight gain, high blood pressure, high cholesterol, diabetes, all of which contribute to a higher risk of cardiovascular disease. 

The opposite is also true. By maintaining a healthy, balanced and nutritious diet, we can improve our cardiovascular risk profile. This does not mean that you have to give up on your favourite food and go on a strict diet that is unappetising to you. The key is moderation and gradual incorporation of diet choices that promote heart health, such as opting for steamed or boiled instead of fried food, increasing fruit and vegetable intake, etc.

  • Engaging in an active lifestyle

It is well established that physical inactivity makes us more likely to develop cardiovascular disease, such as myocardial infarction (commonly known as heart attack), as well as cardiovascular risk factors, such as high blood pressure, high cholesterol etc. However, switching from an inactive to active lifestyle is often challenging. 

Start with activities you are comfortable with and achievable targets, such as brisk walking for 20-30 minutes a day, and slowly work up to 150 minutes a week of moderate-intensity aerobic activity. Aside from the benefits for the heart, exercise also helps you feel happier and more energetic, sleep better at night and generally improve your mood and well-being. 

  • Keeping a healthy weight

Despite what looks like a more active nation, overweight and obesity is still on a rising trend in Singapore. About 2 out 5 Singaporeans are estimated to be overweight. Being overweight is a major risk factor for not only cardiovascular disease but also multiple other comorbid conditions that can worsen heart condition, such as diabetes or sleep apnea. 

Diet and exercise play an important role in reducing or maintaining weight. Many people fail to control their weight due to drastic changes in their lifestyle, such as a sudden and unsustainable diet or exercise regime. The key to success is consistency and motivation. Make small changes that are easy to maintain. Another good way to keep it up is asking family and friends to help remind and encourage you (or nudge you). 

  • Cutting back on alcohol consumption

Excessive alcohol consumption is not beneficial for the heart. Alcohol consumption makes it more likely for one to develop high cholesterol, high blood pressure, cardiac events, and generally ages the body. You may also take in excessive sugar when alcohol is consumed as mixed drinks, which has an impact on blood sugar levels. Discuss with your doctor for guidance on an appropriate amount of alcohol to consume for your risk profile. Generally, it is recommended to cut back and drink in moderation to protect the heart and the body. 

Risk factors of heart diseases

Risk factors of heart diseases

5.2. Manage Related Medical Conditions that are linked to Cardiovascular Diseases

Several medical conditions have strong linkage with cardiovascular disease, including hypertension, high cholesterol, diabetes, sleep apnea and mental illnesses. Lowering cardiovascular risks therefore requires detection and management of these conditions. 

High blood pressure: Over 7 in 10 Singaporeans aged 60 and above have high blood pressure, which is closely linked to cardiovascular disease. Detected early, hypertension can be managed effectively with medications and lifestyle changes. The challenging part is that many people are not aware of their condition. Read our in-depth article on high blood pressure to know more about its causes and complications, how to get diagnosed and treated early here.

High cholesterol: Cholesterol is a type of fatty substance that exists in the blood, necessary for tissue and hormone production in the human body. However, cholesterol is harmful when it exceeds the level that the body needs. It builds up into plague that hardens and narrows the arteries. When the artery to the heart or brain is blocked, a heart attack or stroke happens. 

An individual’s cholesterol profile is measured with a blood test. Once diagnosed, high cholesterol, or hyperlipidaemia, can be managed with medications. Lifestyle changes, especially dietary changes are an important part to control cholesterol, such as reducing intake of saturated fat and increasing intake of fruit, vegetable, lean protein and whole grain.  

Diabetes: People with diabetes are up to 4 times more likely to develop cardiovascular disease compared to those without. In fact, diabetes patients are recommended to go for heart screening from the point of diabetes diagnosis. Unmanaged diabetes can lead to cardiovascular disease such as stroke, coronary artery disease, and other diseases such as kidney diseases, Alzheimer’s and more. For those with diabetes, managing diabetes is crucial to manage cardiovascular disease risks. Find out more about diabetes and how to prevent its complications from our comprehensive guide to diabetes in Singapore here

Sleep apnea & other sleep disorders: Sleep quality has been associated with heart disease. Chronic snoring problems, sleep apnea or other sleep disorders put people at additional risk of developing cardiovascular disease. Thus, it is important to manage sleep disorders to protect our heart health. Learn more about how lack of sleep affects your heart and what you can do to sleep better here.   

Mental illness: Mental health has an important impact on our heart health, as we have written about in our article on the intricate link between mental health and heart health here. Seek medical help to overcome mental problems, big or small; and let your doctor know of your mental health history during heart screening as well. Stress management also plays a role in controlling cardiovascular risk, as stress has been proven to have detrimental effects on both heart and mental health.   

Ninkatec_Infographic_Medical conditions that cause cardiovascular diseases

Medical conditions that can cause cardiovascular diseases

5.3. Monitor Non-modifiable Risk Factors of Cardiovascular Disease

Non-modifiable risk factors are those that we have no control over. Though we cannot change it, it is important to know how they might affect our total risk profile and proactively monitor them. 

For cardiovascular disease, the commonly known non-modifiable risk factors include: 

  • Age: Cardiovascular incidents happen more often among those above 65
  • Gender: Men are observed to be at higher risk of heart attack throughout their life compared to women. However, women are at higher risk during certain periods of their life, such as during pregnancy, or after menopause.  
  • Family history: Genetic and family lifestyle may make certain individuals more predisposed to cardiovascular disease. 
  • Personal history of cardiovascular disease: Having been through one cardiovascular incident puts a person at a higher risk of a recurrence. 

6. Takeaway Message

A heart health check is an effective step to prevent cardiovascular disease, allowing us to take control of our cardiovascular health. Some people may find health screening stressful or unnecessary. However, the benefits of early diagnosis and treatment outweighs the physical, mental and financial toll of treating cardiovascular diseases at an advanced stage. It is time to assess your cardiovascular risk if you have not done so! 

Ninkatec provides heart health checks in our clinic as well as in the comfort of your home. We combine technology with a patient-centric approach to provide preventive heart care to your doorstep. For example, we use an advanced wearable ECG measurement device called RootiRx to measure your heart rhythm even when you sleep, instead of the cumbersome traditional ECG method which can only be done at a clinic. We also provide treatment & management plans for related conditions such as hypertension, diabetes, sleep apnea, etc. 

Reach out to Ninkatec Care Team today via call, WhatsApp, email or the form below for a consultation.


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