ABCs of CVD Prevention in the Workplace (and at Home)

The COVID-19 pandemic has affected the world for almost two years, with the death toll reaching millions to date. However, this grim statistic is dwarfed by the undisputed world’s number 1 killer – cardiovascular disease (CVD).

In Singapore, ischaemic heart disease consistently ranks as one of the top causes of both hospitalisation and death (Ministry of Health Singapore statistics). Moreover, the risk factors that contribute to ischaemic heart disease have continued to increase over the years. These risk factors are high blood cholesterol, high blood pressure, diabetes, obesity and cigarette smoking. In addition, due to the pandemic, many have also exercised less due to fear of contracting COVID-19. This sedentary behaviour also adds to the risk of heart disease in the long term.

Thankfully, it’s never too late to protect yourself and take preventive steps to protect your heart. We can adopt lifestyle changes that can be as easy as A, B, C.

Assess your risk
If you are 40 years old or above, go for a health screening to diagnose any cardiovascular risk factors early. Although you may feel well, chronic diseases such as diabetes, high blood pressure, and high blood cholesterol may be creeping up on you without displaying any symptoms in the early stages. Health screening can generally pick up anomalies that point to these chronic diseases or other more serious underlying medical issues that you might not be aware of.

If you are a Singapore Citizen or Permanent Resident, you can enjoy subsidised health screening and follow-up under the national Screen for Life programme.

At the workplace, if you have colleagues or staff aged 40 and above, and have not gone for screening, do consider reminding them to do so.

Blood pressure
If you constantly have a blood pressure reading of more than 140/90mmHg, you have high blood pressure or hypertension. In addition to medication, try to control your blood pressure with various methods. These include weight loss, eating a healthy diet (refer to point “D”), exercising regularly (refer to point “E”) and moderating your alcohol intake.

Blood Cholesterol
Are your blood cholesterol levels high? That depends on whether you have other risk factors that increase your overall risk of heart disease. This risk can be calculated during a health screening. For instance, the same blood cholesterol level may be deemed normal in a healthy 40-year-old with no chronic illness but considered high in a 60-year-old who has hypertension, diabetes and smokes cigarettes.

If your blood cholesterol level is high, you will need to adjust your diet, increase your physical activity, and even consider medication to lower it after discussing it with your doctor.

Cigarette smoking
Do you smoke cigarettes? If yes, quit as soon as possible. If you know someone who smokes, please advise them to quit! Improvements in health occur within minutes after you quit smoking and continue to bring benefits for many years to come. It can be challenging to quit, especially for chronic smokers, but there are many resources that healthcare providers have to help.

Diet
For those with high blood pressure, the DASH (Dietary Approaches to Stop Hypertension) diet has been proven to improve blood pressure – this focuses on fruit, vegetables and whole-grains, as well as lean meats and low-fat dairy products.

The Mediterranean diet has been shown to improve outcomes for patients with coronary artery disease. It comprises fish, nuts, olive oil, beans, legumes, whole-grains, fruit and vegetables.

With Singapore’s rich selection of hawker food, it may be challenging to choose wisely. A good start is to take reference from the Heart Smart Eating techniques by the Singapore Heart Foundation.

Exercise
Do you clock 150-300 minutes of moderate-intensity aerobics physical activity a week? Prolonged inactivity not only increases the risk of heart disease, but also diabetes, cancer and even death.

For starters, limit the amount of sedentary time and replace it with activities of any intensity. Those working from home or desk-bound at work can take breaks every 30 minutes to stand and stretch or walk around the house/office. Instead of the lift, take the stairs whenever you can, do bodyweight strength exercises like planks, push-ups, and sit-ups. Try dancing or following online exercise classes, or just bring your kids or pets out for a walk!

If you are aiming to do more, try to achieve 150-300 minutes of moderate-intensity aerobic physical activity (e.g. brisk walking, jogging, swimming or cycling) a week, as well as at least 2 days of muscle and bone strengthening activities (e.g., weight training, pilates, body weight calisthenics).

Now that you are aware of the A, B, Cs to prevent heart disease, you can do your part to improve your own heart health, as well as those around you. Together, we can cultivate a heart-healthier environment for all.

Article is contributed by Dr Yeo Tee Joo, Committee member of the Singapore Heart Foundation’s Cardiac Rehabilitation and Heart Wellness Centres. He is also a cardiologist and the Director of the Cardiac Rehabilitation Unit at the National University Heart Centre, Singapore.