Singapore Heart Foundation

Global

Cardiovascular disease is the leading cause of death globally and is projected to remain so. It has no geographic, gender or socio-economic boundaries.

Every year, heart disease and stroke causes as many deaths as HIV/AIDS, tuberculosis, malaria and diabetes plus all forms of cancer and chronic respiratory disease combined.

An estimated 17.1 million people died from cardiovascular disease in 2004, representing 29%of all global deaths and occurring almost equally in men and women. Of these deaths, an estimated 7.2 million were due to coronary heart disease and 5.7 million were due to stroke.

By 2030, almost 23.6 million people will die from cardiovascular disease every year. The largest increase in number of deaths will occur in the South-East Asia Region.

Source: World Health Organisation

United States

In the US, deaths from heart disease and stroke are reportedly on the decline. However, risks are still too high.

In February 2008, new mortality data from the Centers for Disease Control and Prevention (CDC) showed that, since 1999, coronary heart disease and stroke age-adjusted death rates were down by 25.8% and 24.4% respectively.

However, death rates could begin to rise again in years ahead. This is because all of the major risk factors for heart disease and stroke are still too high and several are actually on the rise.

Source: American Heart Association

Europe

Cardiovascular disease is the main cause of death in the European Union (EU), killing over 2 million people every year.

Moreover, statistics published in February 2008 indicated that CVD across all Member States was estimated to cost the EU economy €192 billion a year.

Trends are also different across the EU and the wider European region. Although CVD mortality is falling in most Northern, Southern and Western European countries, it is not falling, or not nearly as fast, in Central and Eastern European countries.

Source: European Heart Network

Singapore

Everyday, 15 people die from cardiovascular disease (heart disease and stroke) in Singapore. Cardiovascular disease accounted for 32.4% of all deaths in 2008. This means that 1 out of 3 deaths in Singapore is due to heart disease or stroke.

DEATHS FROM CARDIOVASCULAR DISEASE

	2006	2007	2008
Total No. of Deaths	16,393	17,140	17,222
% of Total Deaths
Ischaemic Heart Disease	18.5%	19.8%	20.1%
Cerebrovascular Disease (including stroke)	8.9%	8.7%	8.3%
Other Heart Diseases	4.3%	4.3%	4.0%
Total %	31.7%	32.8%	32.4%

Total	5,197	5,622	5,580

Source: Ministry Of Health

DEATHS FROM CARDIOVASCULAR DISEASE

Breakdown by Gender (%)

2008	Total	Male	Female
Total No. of Deaths	17,222	8,735	7,481
% of Total Deaths
Heart & Hypertensive Diseases	24.4%	26%	22.4%
Cerebrovascular Disease (including stroke)	8.3%	6.9%	10.1%

Total %	32.7%	32.9%	32.5%

Source: Report on Registration of Births and Deaths 2008 by the Registry of Births and Deaths, Immigration and Checkpoints Authority Singapore

Women and Cardiovascular Disease

Heart disease and stroke combined is the leading cause of death among women in Singapore but many are still unaware of of the dangers posed by this “silent killer”.

In the Singapore Heart Foundation’s Go Red For Women Heart Health Awareness Survey in 2006 and 2009, less than 10% of the respondents (8% in 2006 and 9% in 2009) were aware that heart disease and stroke is the No. 1 killer of women.

Other alarming findings of the 2006 & 2009 Survey:

Only 12% of the respondents spoke about their risk of heart disease with their doctors (general practitioners) for the past 12 months (2006).
27% of the respondents thought that there was nothing they could do to prevent a heart attack (2006).
Over a third (35%) felt they were at low risk for a heart attack for a woman their age. 20% did not know their risks. (2009)
About a third (32%) did not know women were more likely to die from heart disease after menopause than before. 20% believed this statement to be false (2009).
Close to half (42%) of women polled did not associate chest pains with heart attacks (2009).
Nearly half of the female respondents identified breast cancer and other cancers as the top cause of death among women in Singapore.

Risk Factors
The Ministry of Health conducted a National Health Survey in 2004 to find out the level of diabetes, high blood pressure and other risk factors for heart diseases and stroke.

Diabetes mellitus
The prevalence of diabetes among adults fell from 9.0% in 1998 to 8.2% in 2004. A higher proportion of men were diabetic (8.9%) compared with women (7.6%). As of 1998, Indians had the highest prevalence of diabetes (15.3%), compared with Malays (11.0%) and Chinese (7.1%). Malay females have shown the most progress since the 1998 survey with significant decline in diabetes from 14% in 1998 to 10% in 2004.

The survey also found that a higher proportion of diabetics were aware of their condition. Among the diabetics, the proportion of those whose condition had not been diagnosed previously fell markedly from 62.1% in 1998 to 49.4% in 2004.

High Blood Pressure
The high blood pressure (hypertension) level of adults declined from 21.5% in 1998 to 20.1% in 2004. A higher proportion of men were hypertensive (24.5%) compared to women (15.9%). Among the ethnic groups, the hypertension level was highest in the Chinese (20.8%), compared with Malays (18.1%) and Indians (16.7%). The decline in percentage of Malay females suffering from high blood pressure was most significant compared to females in other ethnic groups (from 27% in 1998 to 18% in 2004).

Among those found to have hypertension, the proportion of previously-undiagnosed hypertensives declined from 55.0% in 1998 to 39.7% in 2004.

Smoking
The prevalence of daily cigarette smoking among adults declined significantly from 15.2% in 1998 to 12.6% in 2004. Daily cigarette smoking was much more prevalent among men (21.8%) than women (3.5%). Malay men had the highest prevalence of daily cigarette smoking (29.9%), compared with Indian men (22.4%) and Chinese men (20.5%). The drop in the percentage of smokers is most significant among the Malay males (from 43% in 1998 to 30% in 2004) and Indian males (from 31% in 1998 to 22% in 2004).

While the proportion of men who smoke daily decreased significantly from 27.1% in 1998 to 21.8% in 2004, the proportion of women smokers remained at about the same level (3.2% in 1998 and 3.5% in 2004). The proportion of young women (18-29 age group) who were daily smokers rose from 5.2% in 1998 to 6.6% in 2004. In this group, smoking was more common among Malays (17.0%) compared to 5.1% among Chinese and 2.4% among Indian young women.

Regular Exercise
The proportion of adults aged 18 to 69 years who exercised regularly increased significantly from 16.8% in 1998 to 24.9% in 2004. The improvement is seen in both genders and all three ethnic groups. Regular physical exercise was most prevalent among Indians (28.8%) compared with Malays (28.0%) and Chinese (24.0%). It still remains that more men are exercising regularly compared to women.