Wellbeing / 22 Jun, 2020

The five most common chronic medical conditions in Singapore

Dr Goh Lit Ching

1. Diabetes Mellitus

Diabetes is a medical condition in which blood glucose levels remain persistently higher than normal. This happens when the body does not produce enough (or any) insulin. Diabetes affects 1 in 9 Singaporeans.

Common symptoms of diabetes include increased thirst and hunger, frequent urination and sudden unexplained weight loss, although some people may not have any symptoms at all. Diabetes can be caused by your genetics, a sedentary lifestyle, age or during pregnancy (gestational diabetes). Complications of diabetes include kidney failure, eye conditions, diabetic foot ulcers, nerve complications and heart attack. The most effective way to prevent diabetes is through lifestyle management. For someone diagnosed with diabetes, diet control with adequate exercise and ensuring you continue to take your medication as prescribed by your doctor can minimise complications caused by this chronic disease.

2. High Blood Pressure (Hypertension)

Hypertension is a condition in which blood is pumped around the body at too high a pressure. Less than 1 in 4 Singaporeans aged 30 to 69 years have hypertension. The risk of hypertension increases with age, due to the increased hardening of blood vessels as part of natural ageing. In the 60 to 69 years age group, more than 1 in 2 people have hypertension.

Hypertension may not present with any symptoms at all. Occasionally, you may have headaches or giddiness when the hypertension is severe. Common risk factors of hypertension include obesity, diabetes, genetics and age. The cause can also be unknown. Complications of hypertension include heart disease, stroke, kidney failure and peripheral artery disease. Hypertension can be prevented through lifestyle management including healthy diet, regular exercise, cutting down on alcohol and stopping smoking. Treatment includes anti-hypertensive medications in combination with lifestyle management.

3. High Cholesterol (Hyperlipidemia)

High cholesterol is a condition where there is an excessive level of fatty substances in the bloodstream, which increases your risk of developing heart disease and stroke. Around 1 in 6 Singaporeans have high cholesterol.

High cholesterol generally does not cause any symptoms. Symptoms are usually related to the complications caused by this condition, such as heart attacks, angina pain, peripheral vascular diseases and stroke. Common risk factors include genetics, sedentary lifestyle and unhealthy diet. Screening for high cholesterol is important to ensure anti-lipid treatment is given and the target healthy level of cholesterol in the body is achieved. Other than medications, high cholesterol can be prevented through lifestyle management such as diet control, physical exercise and regular health screening to monitor your cholesterol levels.

4. Stroke

A stroke happens when the blood supply in the brain is blocked or bursts, which in turn causes the cells in the affected part of the brain to die. When this occurs, the functions that are controlled by that part of the brain are lost. A stroke is a medical emergency because the damage done is irreversible unless treatment is provided in time. Stroke is the fourth most common cause of death in Singapore, accounting for more than 10 percent of all deaths. In Singapore, 3.65 percent of the population has had a stroke in the past and there are 26 new stroke cases every day. The burden of stroke in Singapore is expected to rise in the future with our ageing population.

The symptoms of stroke will depend on which part of the brain is affected. You may also experience a few symptoms affecting different parts of the body. Some common symptoms include sudden numbness or weakness (usually on one side of the body), difficulty speaking or understanding speech, sudden difficulty seeing in one or both eyes, sudden difficulty in walking, giddiness and loss of balance. Difficulty in swallowing and loss of bladder and/or bowel control can also occur.

Common risk factors for stroke include smoking, alcohol consumption, sedentary lifestyle, unhealthy diet, genetics, age and association with other medical conditions such as hypertension, high cholesterol, obesity and diabetes. Leading a healthy lifestyle is an important way you can prevent a stroke from occurring, including having a healthy diet, regular physical exercise, cutting down on alcohol and stopping smoking.

5. Heart attack (Myocardial Infarction)

Heart attack, also known as a myocardial infarction, occurs when blood flow to part of the heart is blocked, causing poor supply of oxygen to the heart muscles. If not treated promptly, the affected heart tissue dies. Heart attack is one of the leading causes of death in many parts of the world. Every day, 17 people die from cardiovascular disease in Singapore. Heart attack is the second most common cause of death in Singaporeans after cancer.

Some people may have chest pains, shortness of breath, profuse sweating or pain in the jaw or arm when a heart attack happens, while others may have no symptoms at all. Common risk factors include genetics, age, unhealthy lifestyle and association with other medical conditions such as hypertension, high cholesterol, diabetes and obesity. Complications of heart attack are mainly related to heart muscle damage and can be life-threatening in severe cases, causing heart failure, abnormal heart rhythms and heart valve disease. Heart attacks can be prevented through lifestyle management and achieving good cardiovascular health, including regular health screening to detect any underlying chronic medical conditions that can be treated and controlled.

What is the role of health screening?

With each of these five common chronic conditions, you may have noticed that while many often don’t show any symptoms, they can result in disabling and life-threatening complications. Health screening is important as it can help you find out if you have a medical condition, even if you do not have any signs or symptoms. Early detection and treatment can help you take control of your health and change the prognosis of the disease. This is why it is crucial to get screened even if you feel perfectly healthy.

The Health Promotion Board (HPB) recommends several different screening tests as a general guideline which you should consider as you age. You are encouraged to discuss any health concerns with your doctor when you go for health screening so that a risk assessment can be performed, and relevant diagnostic tests can be organised on a case-by-case basis.

References

For a full list of references, click here.
  1. Health Hub. (2019). Chronic Diseases: Understanding the Medical Conditions and their Causes. Retrieved on 3 June 2020 from https://www.healthhub.sg/a-z/diseases-and-conditions/96/topics_chronic_diseases
  2. Singapore Heart Foundation. (2018). Singapore Statistics. Retrieved on 3 June 2020 from https://www.myheart.org.sg/my-heart/heart-statistics/singapore-statistics/
  3. SingHealth. (2020). SingHealth. Retrieved on 3 June 2020 from https://www.singhealth.com.sg/
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