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Heart Disease and Stroke

Dr. Derek Koh

Head, Health Screening at Thomson Wellth Clinic

MBBS (Singapore), GDFM (Singapore)

Dr. Derek Koh practises preventive medicine through tailored health screenings & wellness programmes including the management of Andropause, Menopause and Obesity.He is also Board Certified in Anti-Ageing; has attained his Fellowship with the American Board of Anti-Ageing.

Table of Contents

Heart disease and stroke (cardiovascular disease) combined is the leading cause of death among women in Singapore but many woman are still unaware of this ‘silent killer’. In 2009, less than 10% of the women who took part in the Singapore Heart Foundation’s Go Red for Women Heart Health Awareness survey were aware of this important fact.

It is common knowledge that high cholesterol levels contribute significantly to heart disease. The risk for heart disease in women is lower than men during their childbearing years but rises sharply after menopause. This is due to the loss of oestrogen protection as oestrogen lowers LDL (bad cholesterol) while raising HDL (good cholesterol).

When women enter menopause and oestrogen levels decline, this will lead to an increase in levels of ‘bad cholesterol/LDL’. Hence, postmenopausal women will then face similar risks of cardiovascular disease as men of the same age. High cholesterol is only one of the many risk factors of cardiovascular disease.

Symptoms of Heart Attack

For both men and women, the most common symptom is chest pain or discomfort, described as a tight or heavy feeling on the chest. Women are more likely than men to have heart attacks that present without chest pains, and they are more likely to die of a heart attack than men (study in the Journal of the American Medical Association in 2/2012). Other signs of a heart attack that women experience are:

  • Shortness of breath
  • Feeling faint
  • Nausea
  • Breaking out in cold sweat
  • Pain in the arms, back, neck or jaw

What are the risk factors?

Women over 50 years of age or you are menopaused:

  • Family history of heart disease
  • High Blood Pressure
  • Diabetes
  • High Total Cholesterol (>200mg/dL) and low HDL (<40mg/dL)
  • Overweight
  • Smoker
  • Drinks excessively (more than 2 drinks of alcohol almost every day)

How do we reduce the risk of a heart attack?

1. Eat healthily

  • Avoid consuming food with saturated fat
  • Reduce animal fat (such as ghee, butter, cream) and processed foods (such as cookies and cakes)
  • Eat more whole grain, fruits and vegetables

2. Exercise to help reduce bad cholesterol and increase the food cholesterol

  • Engage in exercises of moderate intensity such as brisk walking and swimming, at least 20 to 30 minutes, 5 times a week

3. Lose weight if you are overweight

  • Unwanted weight gain is one of the symptoms in women after menopause. Losing as little as 5 to 10 percent of body weight can lead to an improvement in cholesterol levels

4. Get your cholesterol and blood pressure checked regularly

  • If you are over 50 and have high cholesterol levels or other risk factors, do consult your doctor
  • Some women may not be able to bring their cholesterol levels down, despite lifestyle changes and medications may then be prescribed

5. Control your diabetes

6. Stop smoking

  • Smoking increases the risk of heart attack by 2 to 3 times as it causes more plaque to form in the arteries

7. Reduce your alcohol intake

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