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Publication Date : 06-03-2013
They top obesity and smoking rates; least active among races in screening
High rates of obesity and smoking already put Malays at risk of heart attacks, yet this group is also the least active in getting screened and looking for treatment.
This double whammy could explain why Malays have leapfrogged Indians as the highest risk group in Singapore, as The Straits Times reported last month.
In 2011, there were 439.2 heart attacks per 100,000 people for Malays, compared to 421.5 for Indians and 173.2 for Chinese. Death rates were also higher for Malays.
National University Heart Centre Singapore (NUHCS) director Tan Huay Cheem said there is a need to educate the community on heart disease given the prevalence of risk factors among Malays.
About 24 per cent of Malay adults are obese, compared with 16.9 per cent for Indians and 7.9 per cent for Chinese, according to the latest National Health Survey.
Daily smoking rates were also highest at 26.5 per cent, compared with 12.8 among Chinese and just 10.1 among Indians. The same survey found that among those aged 40 to 69, Malays were the least active in participating in community health screenings - only 53.6 per cent checked their cholesterol levels at least once in the past three years. Among Indians, the figure was 68.5 per cent, and for the Chinese, 61.6.
More risk factors like high cholesterol levels increase the risk of heart disease, said Tan Tock Seng Hospital cardiologist David Foo.
Signs also point to a delay in getting treatment. At NUHCS, Malays take a longer time to seek medical help when they suffer a heart attack, clocking the longest time between symptoms first appearing to having a stent or balloon implanted to open the clogged vessel. The sooner treatment is carried out, the less damage the heart muscle suffers.
In 2011, 42.8 per cent of Malay patients reached the hospital in under two hours, compared with 43.6 per cent of Chinese, and 44.2 per cent of Indians.
"We often tell heart patients that 'time is muscle'. The longer it takes for patients to receive medical help, the higher the risk of mortality," said Professor Tan.
National Heart Centre deputy medical director Terrance Chua said anyone with symptoms such as chest discomfort lasting for more than 10 to 15 minutes should seek medical help without delay.
When operations agent A'bdassalam Yuseri, 54, suffered a heart attack last April, it took about three hours after the onset of chest pains and breathlessness before he sought help. Doctors diagnosed two blockages in his heart and high cholesterol levels. At the time, he weighed 76kg, and with a height of 1.53m, his body mass index was above 27.5, which classified him as obese and put him at high risk of a heart attack.
"I had a very good appetite, and my stomach grew bigger and bigger. But I have since lost 10kg, and am more careful about what I eat. No more oily food like nasi briyani. I also go for walks a few times a week," said A'bdassalam, who had stents inserted. Prior to his health scare, the father of three had no idea that the symptoms he suffered pointed to a heart attack, or that his lifestyle put him in danger.
Changi General Hospital cardiology head Tong Khim Leng said organising forums and talks with Malay-speaking experts could be ways to increase awareness among the Malay community.
The Singapore Heart Foundation is working to attract the Malay community in its outreach efforts - like giving free tickets to its upcoming May symposium on women and heart health, which normally costs $20 each, for example. Commercials for its "Go Red for Women" movement - aimed at improving women's knowledge on heart health - will also be aired in Malay, as well as English and Mandarin.
Greater awareness of health problems has helped the Indian community. Mount Elizabeth Novena Hospital cardiologist Dinesh Nair said the number of Indians undergoing health screenings to detect heart problems has doubled in the past five years as "many in the community began to get screened early, particularly those with a family history of heart attacks".