October 2005, Police Life

Prevention is Better Than Cure
by Insp (V) Yap Boh Tiong, Public Affairs Department

You are at the prime of your life, with no history of chest pains, high blood pressure or high cholesterol. Dying from a heart attack is probably the furthest thing from your mind, but should it be?

In June this year, the National Heart Centre released study findings showing that every five to six days, a person in his 20s or 30s suddenly collapses adn dies. In more than nine out of 10 cases, the death was caused by heart disease. Unfortunately, most of the victims appeared healthy up till the day they died. In fact, some suffered their fatal heart attacks during their regular exercise routine. To Dr Michael Lim, however, there is no mystery. The Medical Director of the Singapore Heart, Stroke and Cancer Centre (SHSCC) and Member of Parliament for Pasir Ris - Punggol GRC said, "If you go to the major hospitals and look at the last 100 people to suffer heart attacks, you will realise that many of them do not have serious or significant blockages in their arteries."

While many people think that heart attacks result from the gradual blockage of the heart arteries, the reality is far different. According to Dr Lim, who was recently elected President of the Asia Pacific Society of Cardiology, many people suffer heart attacks when there is a minor narrowing of their arteries due to plaque forming on the walls, which tear when aggravated by exercise - a condition called "plaque rupture". To repair the tear, the body forms a blood clot that may eventually result in a heart attack or stroke.

Who is at Risk?
The Singapore Heart Foundation's web site states that men, older people, and people with a family history of stroke and heart disease, tend to face a higher risk of cardiovascular disease. These are factors that are beyond an individual's control. Other risk factors that are within an individual's control are:

1. High cholesterol levels
2. High blood pressure
3. Diabetes mellitus
4. Being overweight / obesity
5. Smoking
6. Lack of exercise
7. Stress

How Do You Reduce the Risks?
In order to control the above risk factors, it is important to lead a healthy lifestyle, and an important part of a healthy lifestyle is to have a healthy diet and control your weight.

Some basic guidelines are:

1. Choose a nutritious diet from a wide variety of food
2. Reduce the size of the servings
3. Eat less fat: select fish, poultry and lean meats; trim excess fats and remove the skin
4. Eat less sugar: reduce the amount of sweet food such as cakes, soft drinks, biscuits. Reduce the sugar in recipes. Use fresh fruit instead of canned ones
5. Increase the intake of complex carbohydrates such as rice, potatoes, and whole grain bread
6. Eat more bread and cereals, fruit and vegetables
7. Drink less alcohol
8. Use less salt as this may increase your blood pressure
9. Drink more water
   

Regular exercise is also beneficial to health. However, Dr Lim cautioned against overly strenuous exercise as this may exert too much strain on the heart and lead to a heart attack. Another key ingredient to a healthy lifestyle is to have regular medical check-ups. Some simple checks include checking your blood pressure and cholesterol levels. While check-ups may be able to pick up serious blockages, detecting minor blockages is trickier. Many of the diagnostic equipment available today may in fact return a normal reading, lulling people into a false sense of security.

How Does Advanced Technology Help?
There is a silver lining behind these dark clouds though. Medical imaging technology has progressed and it is now possible to obtain clearer and more detailed images of the arteries and organs. Some computed tomography (CT) scanners can even capture accurate four-dimensional images of the arteries, and any organ in the body. This allows medical specialists to detect a variety of diseases in their early stages, for example the minor narrowing of the arteries, and quickly prescribe treatment.

The new generation four-dimensional multi-detector CT scanner has another advantage that many people will appreciate - it is non-invasive and painless. Previously, cardiac checks involved having a thin tube threaded through the blood vessel, which is uncomfortable. With the CT scanner, patients simply have to lie still as they are put through the scanner.

According to the Singapore Heart Foundation's web site, other non-invasive tests to diagnose heart disease include chest x-ray, electrocardiography / electrocardiogram, echocardiography and magnetic resonance imaging (MRI). The phrase, "no pain, no gain", has been rendered obsolete.

As with all other things in life, prevention is better than cure. Dr Lim foresees that by making disease diagnosis much more accurate, painless and fast, the latest technology in medical imaging can help bring about the "paradigm shift in medicine from treatment to prevention".

Regular medical check-ups will be able to pick up ailments before they get too serious and treatment gets too complicated. This will in turn result in a decrease in healthcare costs and also eventually prolong the lifespan of the population.

Despite all the progress in medicine, it is still up to you to take an active role in looking after your health. "It is strange how people put so much care and attention into their cars but not their health," said Dr Lim. "Just as you send your car for regular servicing, you should also go for regular medical check-ups."