EDITOR S NOTE FEATURE Dear readers, PATRON President S R Nathan NATIONAL HEART COUNCIL HOLD YOUR HEARTS, I love to read. Nothing is more relaxing than

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1 heartline Official Publication of the Singapore Heart Foundation Mar May Hold Your Hearts, Mums-to-be Heart to Heart with Dee Dee 吸烟的女性比男性更易患心脏病 Dari Hati ke Hati Bersama Dee Dee MICA (P) 222/12/2008

2 EDITOR S NOTE FEATURE Dear readers, PATRON President S R Nathan NATIONAL HEART COUNCIL HOLD YOUR HEARTS, I love to read. Nothing is more relaxing than snuggling on the sofa or swinging in a hammock and reading a good book; hair raising thrillers, nail biting suspense novels, thought-provoking poetry or enriching business books. One of the 2008 business books worth picking up is Outliers. In the book, Malcolm Gladwell writes about the research done by Steward Wolf in the 1950s. Wolf and Bruhn had to convince the medical establishment to think about health and heart attacks in an entire new way. They had to look beyond the individual. They had to understand the culture he or she was part of, and who their friends and family were, and what town their family came from. They had to appreciate the idea that the values of the world we inhabit and the people we surround our self with have a profound effect on who we are. * Isn t this what the Singapore Heart Foundation believes in from its inception? What has changed over the last half century? Not much. Over the years, we proclaimed the message that heart-healthy living is a personal responsibility, but that as individuals, we cannot live in isolation. We influence our surroundings and our surroundings influence us. Therefore, it is critical that we keep pushing the message that in order for a healthy living campaign to be successful, to impact lives, it must target the entire family, the entire community. Although men and women are equal as human beings, the impact on heart health by the mother of the family is probably bigger. Mothers are nurturing the future of the nation. We have to ensure that women in our society understand the causes of coronary artery disease, recognise their own risk profile, acknowledge symptoms and are well-equipped to deal with coronary artery disease emergencies. We also have to recognise their uniqueness in body, in psyche, in social interaction and thus target research in gender specific terms. This basic research will result in practical applications for diagnostics and treatment that meet women s unique needs. This issue of heartline is dedicated to heart healthy living for women. Enjoy it. President Dr Richard Hu Vice-Presidents Mr Sat Pal Khattar Mr Lee Khoon Choy Mr Shaw Vee Meng Mr Arthur Tay Chairman Emeritus Dr Low Lip Ping 38 th BOARD OF DIRECTORS Chairman A/Prof Terrance Chua Vice-Chairmen Dr Tan Yong Seng Ms Tan Lee Chew Honorary Secretary A/Prof Tan Huay Cheem Assistant Secretary Mr Goh Chiew Seng Honorary Treasurer Mr Chong Chou Yen Members Dr Chee Tek Siong Dr Goh Ping Ping Mdm Koh Teck Siew Dr May Lwin Dr C Sivathasan Mr N Sreenivasan Mrs Tan-Wee Beng Yan Dr Tham Kwang Wei Dr Wu Dar Ching Acting Chief Executive Officer Mr Vernon Kang Special Advisor Mr Tan Boon Chiang Honorary Advisors A/Prof Koh Tian Hai Mr Liak Teng Lit Mr Lim Soon Hock A/Prof Lim Yean Teng Dr Lily Neo Mr Tan Kin Lian Mr Wong Yew Meng MUMS-TO-BE! Pregnancy in heart disease is a rare condition but can carry with it significant risks to the mother and foetus. The prevalence of this condition is found in approximately one to five percent of pregnant women. The most common cardiac conditions range from congenital heart defects like mitral valve prolapse (a disorder in which the heart s mitral valve billows out and does not close properly) to rheumatic heart disease. With advances in surgical techniques for congenital heart defects correction as well as the common heart valve replacement procedures, more females survive their condition. Increasingly, the incidences of women of childbearing age with cardiac concerns are on the rise. Problems like pulmonary hypertension, Marfan syndrome (an inheritable disorder of connective tissue affecting the cardiovascular system) and cyanotic congenital heart disease (congenital heart defects resulting in low oxygen levels in the blood) form the highest risk group. Due to the low prevalence and complicated nature of By Dr James Yip, Senior Consultant and Cardiac Nurse Margaret Choong, National Uinversity Heart Centre Singapore, National University Hospital their cardiac conditions, it is therefore necessary that these patients receive specialised care in pregnancy. Cardiac Defects in Pregnancy In pregnancy, there are increased demands created by the foetus as well as the hormonal changes brought about by the pregnancy. This causes a significant increase in the amount of blood pumped out of the heart (cardiac output). At rest, cardiac output will increase by 50% from 4 L/minute to 6 L /minute in early pregnancy. During labour, the cardiac output may rise further due to pain and exertion and decreases by within two weeks after delivery. As such, problems like palpitations (sensation of fast beating heart) and high blood pressure are common during pregnancy. These problems, if untreated, may lead to maternal and foetal complications. Up to eight percent of normal gestations may be affected by hypertensive disorders in pregnancy. Some patients with congenital heart defects may be diagnosed for the first time due to the hemodynamic stresses of pregnancy. As part of our efforts to reach out to the community, I appreciate your feedback. Write to me, share your thoughts. EDITORIAL BOARD Editor Mr Patrick Deroose Patrick Deroose Assistant Editor Dr K Gunasegaran Members Dr Chee Tek Siong Dr C Sivathasan *Outliers. The Story of Success by Malcolm Gladwell, published by Little, Brown and Company, New York (2008) pg Secretariat Mr Vernon Kang Ms Brenda Maderazo Ms Woo May Yin heartline is a quarterly publication of the Singapore Heart Foundation 9 Bishan Place, #07-01 Junction 8 (Office Tower), Singapore Tel: Fax: info@heart.org.sg The information provided in heartline is for educational purposes only. It should not be used for diagnosing or treating a heart problem or a disease and should not be substituted for professional health care. Opinions expressed by contributors and advertisers do not necessarily reflect those of the SHF. The SHF does not endorse any products or services in heartline advertisements. All rights reserved. Copyright is held by SHF. No portion of this publication can be reproduced without the permission of SHF. The SHF-Isetan Foundation Heart Wellness Centre is located at 9 Bishan Place, #07-01 Singapore To find out more details about the cardiac rehabilitation programme, please call or To get your copy of heartline delivered to your doorstep, call for a copy of the subscription form. designed by Fly Design Pte Ltd printed by Image Printers Pte Ltd To advertise, please contact Ms Karen Nah at or karen@flydesign.com.sg 3

3 FEATURE FEATURE SMOKING RISKIER TO WOMEN S HEARTS THAN MEN S Monitoring the Heart Condition Pregnant women may be at increased risk of thromboembolism (complications caused by the formation of blood clots) due to hormonal effects, enlarging uterus and reduced mobility. Thus, the issues of anticoagulation for pregnant women with mechanical heart valves are of a concern to the cardiologist. The drugs used for thinning of the drugs must be carefully selected and kept at optimal levels during pregnancy, as different drugs carry different risks. Other issues like abnormal heart rhythms or high risks of having infection in the heart (endocarditis) need to be watched closely as well. Female patients with a congenital heart defect carry a 2.5% to 18% risk of having a child with congenital heart disease, ranging from a simple lesion to a very complicated heart abnormality. Some rare genetic abnormalities have a 50% risk of transmission to the next generation (Marfan Syndrome and the 22Q11 deletion syndrome a syndrome that affects the heart as well as other bodily systems). Thus genetic counselling of the patient and spouse should take place before conception. Specialised Care for Individual Patients Some doctors are not familiar with the changes that a patient undergoes during pregnancy and the drug therapies that can be employed. Even fewer are familiar with congenital heart disease. Many patients may have been falsely led to believe that they should never conceive due to risk to their and their offsprings well-being. The care and management of each patient is catered according to the condition of the patient and will differ from patient to patient. In conclusion, pregnancy in heart disease is rare and needs special attention when it occurs. It needs to be managed by a team of dedicated specialists, consisting of the obstetricians, cardiologist, anaesthetist as well as the neonatologist, who are familiar with its care. Who should seek advice 1. All women with pre-existing cardiac conditions or congenital heart disease. (Male spouses with congenital heart defects can be referred for genetic counselling) 2. Women with cardiac symptoms during pregnancy (like palpitations, chest pain, breathlessness) 3. Women with hypertension during pregnancy This article was first published in Lifeline, a quarterly newsletter publication by National University Hospital (NUH). Lifeline provides useful information, ranging from medical information to new patient services at NUH. Generally, women get heart disease much later than men, but not if they smoke, a new study by Dr Morten Grundtvig from Innlandet Hospital Trust in Lilehammer, Norway revealed. The study was conducted on 1,784 patients who were admitted for a first heart attack. Women in the study had the first heart attack at the age of 81 if they did not smoke and at the age of 66 if they did a difference of 15 years. Men in the study on average had the first heart attack at the age of 72 if they did not smoke and at the age of 64 if they did a difference of eight years. After adjusting for other heart risk factors like blood pressure, cholesterol and diabetes, the researchers found that difference for women is about 14 years and for men about six years. According to Dr Silvia Priori, a cardiologist at the Scientific Institute in Pavia, Italy, the difference was not minor and that women should realise that they are losing much more than men when they smoke. Dr Robert Harrington, a professor of medicine and spokesman for the American College of Cardiology points out that the difference in how smoking affects women and men is profound. Unless women do not smoke or quit, they risk ending up with the same terrible diseases as men, only at a much earlier age. Dr Ruth Kam, the Research Committee Chairperson of the Singapore Heart Foundation, says that the findings of the study were significant and highlighted the importance of smoking as a risk factor, especially for women, as smoking negates all the protective effects that female hormones have on the heart. Dr Kam further explains that smoking affects the coronary arteries in a number of ways. The harmful chemicals like nicotine cause vessel spasm and toxic gases in cigarette smoke also impair endothelial function, which are the cells lining the arteries. Smoking increases the clotting tendency of the heart, oxidises the cholesterol in the plaques and releases hormones that cause platelets to clump together and initiate the clotting process. All these are events leading to complete obstruction of a vessel which leads to heart attack. Women tend to have smaller vessels than men and so perhaps these negative effects have a greater impact on them, she says. In Singapore, there has been an increase in the number of smokers among women in the younger age group. This is a cause of great concern as it is expected to result in higher incidence of heart disease among women. The National Health Survey revealed that the proportion of young females aged years who are daily smokers rose from 5.2% in 1998 to 6.6% in 4 5

4 FEATURE FEATURE Among these young women, smoking was most prevalent among Malays (17%), compared to their Chinese (5.1%) and Indian (2.4%) counterparts. Dr Goh Ping Ping, Chairperson of SHF s Go Red For Women (GRFW) campaign says: Cigarette smoking has always been a key risk factor our Go Red for Women Campaign wants women to be aware of. It is alarming that even locally, the proportion of female smokers is on the rise, especially young women in the 18 to 29 age group. Women start to smoke as young as a mean age of 15 years old. Given the many harmful effects of cigarettes on the cardiovascular system, this latest study also tells us that cigarette smoking is even riskier to women than to men. Our GRFW campaign will continue to urge women who are non-smokers never to start smoking; and for smokers to quit immediately. Heart to Heart The death and suffering of my family traumatised me. It made me even more determined to adopt and pursue a healthier lifestyle to minimise my risk of developing heart disease and stroke. Dee Dee (Abidah Mahmood), the cheerful and charming Go Red for Women (GRFW) Ambassador for 2008/2009 of the Singapore Heart Foundation (SHF), shares her family s close encounters with heart disease and stroke, her own emotional and physical battle against her unhealthy weight, and her victorious journey to a healthy and confident her today as a credentialed exercise physiologist cum nutritionist and 24/7 health advocate. How would you describe your lifestyle previously? with DeeDee During my school days, I was never active in sports. Then, when I was working as a secretary with Banque Nationale de Paris, I led a sedentary lifestyle. My time spent back then consisted mainly of working in the office and when I met up with friends, we would normally spend much of the time getting together for food. I have always been a food lover. My physically inactive lifestyle together with the accumulation of calories intake from food led to an increase in my weight. What prompted you to have a healthy lifestyle makeover? My weight problem really affected me psychologically and physically when my weight ballooned to a hefty 80 kg. With my height of only 1.55 metres, I was grossly obese and I could not fit into my clothes. Each time I looked at myself in the mirror, I felt depressed and could not bear to see my own reflection. It became very embarrassing shopping for clothes because just trying to fit into a skirt at XXL size was very traumatic. To add to my list of health problems, my knees could not support my excessive weight and I had a knee replacement. My confidence was abysmal that there were times when I refused to go out and avoided meeting people. In desperation, I took a shortcut to losing weight, expecting for easy solution and instant gratification by popping slimming pills and pursuing fad diets. As a result, I suffered from health problems such as gastric pain and I was always feeling lethargic, irritable and prone to sickness. These fad diets also caused a yo-yo effect to my body, leaving me with more fat and less protein than I started off with and feeling even more out of shape than before. Then, I realised all these while that I had taken the wrong path. I eventually found the right solution to my weight problem. I began to adopt a balanced diet and a proper exercise regime. As a firm advocate of healthy lifestyle through proper exercise and nutrition, the opportunity to represent and be the ambassador to one of the recognised bodies such as SHF will open more windows of opportunity for me to reach out to the community so that my experiences can be shared and the noble goal of a better and healthier community can be achieved. What motivated you to stay on track? When I started with my exercise regime and eating a balanced diet, it was not plain sailing. With my obesity and other health problems, it was initially difficult to follow even simple aerobic steps. There was even a time during my gym session that one of the guys mockingly told me to tuck my shirt in, in front of all the gym attendees. In fact, what I was wearing then was a tight body-suit and he actually meant for me to tuck my bulging tummy in. I was dejected and severely humiliated when everyone started laughing. This made me even more determined to prove to myself and to those people that I could succeed. As I progressed into my exercise regime, I saw a marked improvement in my weight and health. All these positive results kept me more determined to press on. Due to sheer determination, I managed to overcome the hurdle. Subsequently, as I managed to achieve my desired goal, I began to influence my peers who shared the same predicament and I became an ardent advocate of a healthy lifestyle. With all the experiences that I had undergone, I became so interested in helping others so I decided to further my knowledge in fitness and nutrition overseas. When I returned to Singapore, I started conducting classes, seminars, workshops and talks to educate others on the benefits of staying healthy in a safe and effective manner through proper exercise and nutrition. I really empathise with people with weight problems, as I was once in their shoes. Their determination to actively follow the exercise and nutrition plan motivates me even further in my quest to reach out to more people, to spread the message of the importance of having a healthy lifestyle. You have a family history of heart disease. Who in the family had/has it and how has this affected you? My dad died of heart disease in 2006 and my brother, at 49 years old, died from stroke last year. My mother is wheelchair-bound due to stroke, which is largely attributed to obesity. My sister and brother, meanwhile, have gout and hypertension. The death and suffering of my family traumatised me. It made me even more determined to adopt and pursue a healthier lifestyle to minimise my risk of developing heart disease and stroke. What encouraged you to be the Go Red for Women Ambassador for SHF? As a firm advocate of healthy lifestyle through proper exercise and nutrition, the opportunity to represent and be the ambassador to one of the recognised bodies such as SHF will open more windows of opportunity for me to reach out to the community so that my experiences can be shared and the noble goal of a better and healthier community can be achieved. A specially designed fitness video by Dee Dee is available at SHF for $15 per copy. The Dee Unravelled Fitness DVD contains a complete fitness regime including cardiovascular, strengthening and relaxation routines plus a music video single SATU. To get your copy, please call /

5 Go Red for Women PUT ON THE LITTLE RED DRESS, GO RED FOR WOMEN! From February to May, red will be the new black. Red is the colour of passion. It is love and anger, courage and sacrifice. It is also a warning. Cardiovascular disease is the leading cause of death globally and is projected to remain so. According to the World Health Organisation, heart disease and stroke combined causes 17.5 million deaths each year as many deaths as HIV/AIDS, tuberculosis, malaria, diabetes, plus all forms of cancer and chronic respiratory diseases combined. Of these deaths, 7.6 million were due to heart attack and 5.7 million were due to stroke. Together, heart disease and stroke represents 30% of all global deaths and occurring almost equally in men and women. In Singapore, heart disease and stroke accounts for one in three female deaths taking the lives of eight times more women than breast cancer. However, only 8% of Singaporean women are aware of this. Cardiovascular disease has no geographic, gender or socio-economic boundaries. This means that no one is safe from heart disease. Women are equally at risk of suffering from a heart attack or stroke as men. This risk increases dramatically when women reach menopause. Thus, it is important for women to be aware of the risk factors and look out for warning signs of heart disease, which has traditionally been regarded as a man s illness. Moreover, the symptoms of heart disease may manifest differently in women, which is why they are often underdiagnosed. Heart disease is mostly preventable so an understanding of this serious health threat can make a life-saving difference. To raise public awareness about heart disease and stroke, the Singapore Heart Foundation (SHF) - taking advantage of various special occasions such as Valentine s Day in February, International Women s Day in March and all the way to Mother s Day in May - will be urging everyone to Go Red For Women. Go Red For Women (GRFW) is an international movement started by the American Heart Association and later adopted by other World Heart Federation member countries. The Singapore Heart Foundation launched the Go Red For Women campaign in Singapore in 2005 to bring home heart health messages to women. The campaign aims to empower women who are the gatekeepers to the family s health with the right knowledge and tools so that they can take better care of their hearts and their families. Since the inaugural GRFW campaign, SHF has organised various public events and awareness programmes, including the symbolic lighting up of iconic buildings, scientific and public forums, fashion shows, community roadshows and supermarket tours, to educate women on the risk factors of heart disease and encourage them to go for regular health screenings. For GRFW 2009, exciting activities have been lined up, with the little red dress taking the centre stage. The little red dress is the international symbol of the Go Red for Women campaign. It is a call for women to band together and take action against heart disease and stroke. Like the little black dress considered by many women to be a wardrobe staple SHF hopes that the little red dress will become a fashion and social statement and serve as a constant reminder to all women of the importance of taking care of their hearts. So maybe it s time to trade your classic little black dress for a more daring and empowering little red dress? Red Dress pins are available at SHF s office and Go Red For Women events at $2 each. This is especially so because most women are not aware that heart disease and stroke is their number one killer. Women are the natural caregivers of the family and yet are the least aware of their own risks for heart disease. 8 Dec 08 - Feb 09 9

6 Go Red for Women Red Alert for Women! Heart Disease and Stroke is the No.1 Killer of women in Singapore and worldwide Women in Singapore are more likely to die from heart disease and stroke than men Women are more likely to suffer from an unrecognised heart attack than men Women s risk of having a heart attack increases after menopause Women are less likely to seek corrective treatments for heart-related diseases compared to men SHF Celebrates Womanhood The Singapore Heart Foundation (SHF) welcomes the month of February with the Go Red For Women campaign. Seeking to promote awareness that heart disease and stroke is the No.1 killer of women in Singapore, women from all ages are invited to participate in activities to celebrate good health and femininity. *Events are subject to changes. For updates, please visit or call / 69. Little Red Dress Fashion Photography Competition Date: 10 February 2009 Students and fashion photography enthusiasts compete with shots taken of women in red dresses in a bid to portray the healthy image of a Go Red Women. the little red dress FASHION PHOTOGRAPHY COMPETITION THE JUDGES The little red dress is the international symbol of the Go Red for Women campaign. Like the little black dress considered by many women to be a wardrobe staple SHF hopes that the little red dress will become a fashion and social statement and serve as a constant reminder to all women of the importance of taking care of their hearts. Singapore Flyer Dressed in Red Date: 10 February 2009 Go Red For Women 2009 is officially launched at the Singapore Flyer with a spectacular display of red lights and decorations. The winners of the fashion phorography competition are announced and guests are invited to enjoy a fantastic view of the city scape aboard the Singapore Flyer. Mary is a young working women in her late 20s. She plays a dual role of being a career women and a mother of 2 children. Mary often finds that she has little time for exercise due to her work and family. She claims that her walk to the MRT is enough exercise for her. Although Mary s father suffers from heart disease and stroke, she never goes for medical check-ups as she feels that she is still young and healthy. She thinks that heart disease is a man s illness. Does this sound familiar? These are some of the common misconceptions about women and heart disease that the Go Red For Women campaign aims to address. Visit for more information. Wear Red Raffles Place Date: 13 February 2009 Working women are encouraged to wear red to work to pledge their support for heart health and to head to the SHF booth during their lunch break to learn more about heart disease and stroke. Put on the little red dress. Go Red For Women! 10 11

7 Go Red for Women Go Red the Singapore Flyer Date: 28 February 2009 Singaporean youth will gather to hold a concert for a cause and prove that heart health starts from young. The concert will feature live bands and performances showcasing the vibancy and energy of young Singaporean artistes. Go Red Health Screening Roadshows Date: March - May 2009 Catch our Go Red team at major supermarkets, heartlands and workplaces as we conduct free health screenings for women. Participate and learn about your risk factors for heart disease! EVENT REVIEWS Volunteers reconnect with their hearts Singapore Heart Foundation (SHF) celebrated its Volunteers Appreciation event with the public forum Reconnect with your HEART on 13 December 2008 at The Singapore Scouts Association auditorium. Annual gatherings and events are organised to express SHF s heartfelt gratitude to its volunteers. Without their dedicated efforts and contributions, SHF will not be able to successfully run its programmes and achieve its goals. The forum provided the volunteers and their family members with helpful and practical information on heart health matters, diet, different types of exercises and stress management. The forum was well-received by the attendees. Only by working together can we reduce the threat of heart disease and stroke. Put on the little red dress. Go Red For Women! Did You Know? 1 in 3 Singaporean women dies of heart disease and stroke )*"+$% &'"($%!!"#$% Go Red For Women Go Red for Women campaign runs from February to May. So keep a lookout for a list of fun and healthy activities in which you and your family can participate. Remember, heart disease is not just a man s illness. Women are at risk too. Luckily for us, heart disease is often preventable. To learn how to do so, visit now! #"*$%,"'$% According to the latest statistics from the Ministry of Health, Heart Disease and Stroke is the No.1 killer, killing 2,535 women and causing 33.4% of all deaths. )"*$%,"+$% Heart Diseases & Stroke Cancer Lung & Respiratory System Diseases Kidney & Disorder of Urinary System Diabetes Mellitus Infectious & Parasitc Diseases Other Natural Causes Students Jump for Joy This year, the Jump for Joy event took on the form of a challenge for amateur teams to showcase their skills. The Singapore Heart Foundation, in line with its Jump Rope For Heart programme, invited schools island-wide to participate in the annual Jump for Joy event on 6 November 2008 at Republic Polytechnic. This year, the Jump for Joy event took on the form of a challenge for amateur teams to showcase their skills. Eight schools with a myriad of interesting team names like Red Hot Rulang and Tampines Titans came to take part. The competition, which was an open category, saw both secondary and primary students demonstrating their skipping prowess. The champions of the event were Rulang Primary School students with skippers from West Grove Primary and Paya Lebar Methodist Girls School (Secondary) coming in as the first and second runner-up respectively. 13

8 EVENT REVIEWS SHF raises $88,000 on Flag Day, thanks to volunteers and donors With the help of student and adult volunteers and generous donations from corporations and individuals, SHF managed to raise about $88,000 on its Heart Flag Day held on 3 December The funds raised will go towards funding SHF s meaningful and worthwhile programmes such as cardiac rehabilitation, Heart Support Fund for needy patients, community-based research, healthy lifestyle and physical education programmes in schools as well as public education initiatives in the community. 管好你们的心, 准妈妈们! 叶伟麟高级顾问医生与钟宝虹心脏专科护士, 心脏内科, 新加坡国立大学心脏中心 怀孕期间患上心脏病是一种罕见的状况, 但一旦发生, 却会对母体及胎儿造成很大的威胁 大约 1 至 5% 的怀孕女性会出现这种状况 最常见的心脏病问题有先天心脏缺陷如二尖瓣脱垂 ( 一种心脏二尖瓣外翻而无法关闭妥当的失常现象 ) 及风湿心脏病等 先进的外科手术能纠正先天心脏缺陷及替换常见的心瓣问题, 因此更多患病女性获救 不过, 处于生育年龄的女性患上心脏病的数目却有上升的趋势 From ART to HEART The Save A Child s Heart Photo Exhibition was launched on the evening of 18 December Singapore Heart Foundation (SHF) was glad to collaborate with the Embassy of Israel to bring the Save A Child s Heart Photo Exhibition to Singapore. His Excellency Ilan Ben-Dov, Ambassador of Israel, A/Prof Terrance Chua, Chairman of SHF and many distinguished guests attended the opening. A video was presented documenting the hope and victorious moments of children around the world affected by heart diseases and their families, as well as the sacrifice and determination shown by the Israeli doctors who persevered to save these young lives. The photo exhibition was open to the public and held at the National Library, Victoria Street from 19 to 29 December Reborne partners SHF to tackle obesity and promote heart health Leading proactive health care company The Reborne Group ( and Singapore Heart Foundation (SHF) have come together to tackle obesity and promote heart health in Singapore. Mr Lars Brittsjo, CEO of Reborne and Mr Vernon Kang, CEO of SHF view lifelong ideal weight management as a key strategy to preventing or reducing the risks of weight-related chronic illnesses such as heart disease, stroke, type 2 diabetes mellitus and some forms of cancer. 一些问题如肺高血压, 马凡氏症候群 ( 遗传性的连接组织失常而影响冠状动脉系统 ), 发绀先天心脏病 ( 先天心脏缺陷导致血液中的氧气水平太低 ) 是最危险的状况 由于发病率低且病况复杂, 这些病人在怀孕期间都要接受专科照顾 怀孕期间的心脏缺陷母体在怀胎时需面对胎儿的需求及荷尔蒙的改变, 这会导致从心脏泵出的血液大量增加 怀孕初期, 母体在休息时, 泵出的血液会增加 50%, 从每分钟 4 公升增加至 6 公升 生产时, 由于疼痛及出力, 泵出的血液会更多, 生产后的两周内就会降低 因此, 诸如心悸及高血压都是怀孕期间常见的问题 这些问题如果没有获得解决, 可能会引起母体及胎儿的并发症 约有 8% 的正常妊娠会出现高血压的状况 一些有先天心脏缺陷问题的病人可能就会因为怀孕期间承受血动态变化问题而首次被验证出来 监察心脏情况孕妇的荷尔蒙改变, 胎儿扩大, 行动减少, 出现血栓形成现象的危机也会提高 因此, 心脏医生对装机械心瓣并需服用抵抗血液凝结的孕妇有所担忧 由于不同的药有不同的风险, 怀孕期间用来稀释血液的用药选择及水平都必须非常小心 其它问题如心律失常或心脏受感染也是必须非常小心的状况 患有先天缺陷问题的女性生下带有先天心脏病孩子的危机介于 2.5% 至 18% 之间 孩子的先天心脏病可以是简单的损伤, 也可以是非常复杂的心脏缺陷问题 一些罕见的遗传性缺陷还有 50% 传给下一代的危机 因此, 病人与伴侣在怀孕前应先接受遗传病辅导 个别病人的专门护理有些医生都不太能体会母体在妊娠期间的身体变化及所能使用的药物 了解先天心脏病的医生更加少 很多病人可能已经被误导而以为自己不应怀孕而贻害后代 个别病人的情况不同, 因此护理与处理法也不同 总而言之, 妊娠期患上心脏病的状况罕见, 一旦发生, 病人需要由一组熟悉状况的专业护理人员小心照顾, 他们应包括产科医生, 心脏科医生, 麻醉科医生及新生儿科医生 谁应求证 : 1 所有已有心脏问题或先天心脏病的女性 ( 患有先天心脏病的配偶可以接受遗传病辅导 ) 2 怀孕期间出现心脏病症状 ( 如心悸, 胸痛, 呼吸困难 ) 的女性 3 怀孕期间患上高血压的女性 Mr Brittsjo observes: Obesity is a serious and complex physical condition that can lead to multi-factorial and multi-faceted risks of chronic diseases. Many of these diseases are preventable through responsible lifestyle choices and science-based proactive health care, such as our Xndo Tri-phasic Lifestyle Regimen (TLRTM) for Ideal Weight Management ( We re excited about the partnership we ve established with SHF. Mr Kang adds: With the increasing incidence of obesity, it s no wonder that heart disease and stroke continues to be the number one killer in Singapore and worldwide. We are encouraged by this partnership with Reborne and together, we hope to be able to urge more people to take a proactive role in maintaining a healthy weight to safeguard themselves against heart disease. Mr Lars Brittsjo, CEO of Reborne 这篇文章首次刊登于 Lifeline, 国大医院每三个月的期刊 Lifeline 提供有助信息与常识, 包括医学资料和国大医院的最新服务 新加坡心脏基金自愿从事者 ~ Quek Kem Lian 翻译 14 15

9 吸烟的女性比男性更易患心脏病 据来自挪威 Lilehammer Innlandet Hospital Trust 的 Morten Grundtvig 博士的最新研究表明, 普遍来讲, 不吸烟的女性患心脏病的时间将晚于男性, 但这不包括吸烟的女性 这项研究调查了 1,784 名病患, 这些病患只经历过一次心脏病发作 研究发现, 不吸烟的女性首次心脏病发作的年龄大约在 81 岁, 而吸烟女性则在 66 岁 两者相差 15 岁 而不吸烟男性首次心脏病发作的年龄约是 72 岁, 而吸烟男性却是 64 岁 之间相隔 8 年 在调整了其他可能导致心脏病发作的因素, 比如血压 胆固醇和糖尿病, 研究人员发现, 未吸烟女性和吸烟女性第一次心脏病发作的年龄差为 14 年, 而男性则是 6 年 来自意大利, 帕维亚的科学研究院的心脏内科医生 Silvia Priori 博士表明, 鉴于如此大的年龄差异, 较之于男性, 女性更应当意识到吸烟对于身体的危害 美国心脏学院 (American College Of Cardiology) 的医学教授兼发言人,Robert Harrington 博士也指出吸烟对于男人和女人健康的影响的差异相当大 如果女性有吸烟的习惯, 她们将和男性一样冒着风险患上可怕的疾病, 但患病的时间却远远早于男性 新加坡心脏基金的研究委员会主席甘敏丽医生说, 此项研究的结果很重要, 它强调了吸烟是很重要的致病因素, 尤其是对于女性 因为烟中的有害物质会抵消女性荷尔蒙对心脏的保护作用 甘医生进一步解释, 吸烟对心脏冠状动脉有多种危害 尼古丁等有害化学物质导致血管痉挛, 香烟中的毒气体也会损伤内皮细胞, 一薄层形成血管内壁的专门细胞 吸烟使血液更易凝固, 严重物质氧化硬垢中的胆固醇, 使机体释放使血小板凝固的激素, 将血液凝固, 最终会堵塞而导致心脏病发作 女性心脏血管通常比男性的细, 所以以上的负面因素可能对于女性会造成更大的伤害 在新加坡, 女性吸烟人群逐渐扩大, 并呈现小龄趋势 这种现象引起了关注, 因为大量年轻的吸烟女性可能会导致女性心脏病患者增加 新加坡卫生部的健康调查 (National Health Survey) 显示,18-29 岁的吸烟年轻女性占总体的比率从 1998 年的 5.2% 上升至 2004 年的 6.6% 在这些年轻女性当中, 相对于华族 (5.1%) 和印度族 (2.4%), 马来组吸烟女性 (17%) 占了较大比重 新加坡心脏基金 珍爱女人心 (Go Red For Women) 运动的主席吴彬彬医生说, 吸烟是我们 珍爱女人心 运动总想女性强调的主要致病因素, 女性吸烟人群的扩大足以拉响警报, 尤其是在本地, 越来越多 岁的年轻女性也加入了吸烟人群 有的女性甚至在 15 岁的时候便开始吸烟 根据最新的调查显示, 吸烟不只有害心血管系统, 它对于女性身体所造成的危害远远甚于男性 我们 珍爱女人心 运动将会继续呼吁未吸烟女性永不吸烟, 而吸烟女性马上戒烟 新加坡心脏基金自愿从事者 ~ 冯杨翻译 与 Dee Dee 心与心的交流 作为一个坚决主张通过适当运动和营养维持健康生活方式的倡导者, 这次能代表以及成为新加坡心脏基金 - 一个知名团体的代言人, 为我创造了更多接触社区的机会 这样我就可以和大家分享我的经历, 和实现创造美好健康社区的崇高目标 Dee Dee (Abidah Mahmood), 新加坡心脏基金 2008/2009 珍爱女人心 活动快乐迷人的代言人, 将与大家一起分享她成功走向健康和自信的经历 : 讲述她的家人面临心脏病和中风的经历, 也讲述她自己如何从心理上以及生理上摆脱肥胖症 今天, 她已经是一名有专业资格的运动生理学家兼营养师和 24/7 健康倡导者 您会怎样描述您从前的生活方式? 上学的时候, 我从来都不参加体育活动 之后我在巴黎国民银行当秘书, 我又过上了长期坐着的生活 我的时间, 当时主要是在办公室工作 当和朋友们聚在一起的时候, 通常大家就只想着聚餐 我非常喜欢美食 我懒惰的生活方式和从食物中不断吸取的卡路里使我变得越来越胖 是什么促使您转变成健康的生活方式? 当我的体重大幅飙升到 80 公斤时, 我的身心受到严重影响 我只有 1.55 米高, 当时我严重超重, 已经穿不进以前的衣服 每次从镜子里看到自己, 我都非常沮丧, 不忍心看到自己的模样 我非常害羞, 不敢出去逛街买衣服, 因为即使是试穿一件加大码的裙子也让我的心觉得很受伤 另外, 我的膝盖也已经不承受我的体重, 所以我做了膝关节置换手术 我的自信越来越差, 我时常会拒绝外出, 避免见人 绝望中, 我用了捷径减肥, 把希望寄托在减肥药和流行的减肥食谱上 结果反而给我的健康带来更多的问题, 例如胃痛和昏睡, 易怒和容易生病 这些减肥食谱也造成了游游球效应, 我的体内的脂肪变多, 蛋白质变少 我甚至觉得自己比之前更胖 然后, 我意识到所有这些都是我走的错路 我最终找到了正确的方法解决我的体重问题 我开始采用均衡饮食和正确运动 是什么促使您持续坚持下去? 当我刚开始我的正确运动和均衡饮食的时候, 并不是一帆风顺的 肥胖和其它健康问题使得我连简单的有氧活 动的步骤都跟不上 有一次健身课的时候, 有个家伙在所有同学面前叫我把衬衫塞进去 事实上, 我穿的是一件紧身的运动衣 而他是想让我把我的肥肚子藏起来 当时每个人都开始大笑, 我感到非常沮丧, 觉得自己受到了严重的侮辱 这件事使我更有决心去改善自己 我要证明给那些人看我能成功 随着持续的运动, 我的体重和健康状况有了明显的变化 这些成效坚定了我坚持下去的信心 由于毅力, 我设法克服了重重障碍 后来我终于达成了我理想的目标, 并开始影响和我有同样问题的人 我变成了一个热心倡导健康生活的人 由于以往的经历, 我变得非常热衷于帮助他人, 最后我决定去国外学习, 加深我在健身以及营养方面的知识 回到新加坡以后, 我举办了课程, 研讨会, 工作室和讲座告诉大家用安全有效的方法, 即适当的锻炼和营养, 来保持健康的好处 对于和过去的我一样有体重问题的人, 我更是加强教育 他们积极执行健身营养计划的决心激励我想要去接触更多的人, 向他们传达拥有健康生活方式的重要性的信息 您有家族心脏病史 在您的家庭里谁曾经有或者现在有心脏病呢? 这对您有什么样影响? 我的父亲于 2006 年死于心脏病 我的哥哥于 2008 年死于中风, 当时他才 49 岁 我的妈妈中风之后就一直在轮椅上生活 而造成她中风的主要原因就是过于肥胖 我的妹妹和弟弟同时都有痛风和高血压 死亡和家人所受的苦都令我受到很大的创伤 它使我更加有决心去坚持一种健康的生活来减少我自己得心脏病和中风的风险 是什么令您成为新加坡心脏基金 珍爱女人心 活动的代言人? 作为一个坚决主张通过适当运动和营养维持健康生活方式的倡导者, 这次能代表以及成为新加坡心脏基金 - 一个知名团体的代言人, 为我创造了更多接触社区的机会 这样我就可以和大家分享我的经历, 和实现创造美好健康社区的崇高目标 新加坡心脏基金自愿从事者 ~ 魏娜翻译 由 Dee Dee 特别设计的有关健身的光盘正在新加坡心脏基金出售, 单价新币 15 元 Dee Dee 健身 DVD 包含了一套完整的健身方案, 包括心血管疾病, 加强和放松动作加上音乐录影 想要得到 DVD, 请致电 /

10 ISTIMEWA Dari Hati ke Hati Bersama Dee Dee Sebagai penggalak kuat gaya hidup sihat melalui senaman dan nutrisi, peluang mewakili dan menjadi duta sebuah badan yang ternama seperti SHF akan membuka laluan bagi saya membantu masyarakat agar pengalaman saya dapat dikongsi, dan cita-cita mulia untuk menjadi masyarakat sihat dapat dicapai. Dee Dee (Abidah Mahmood), Duta kempen Go Red for Women (GRFW) untuk tahun 2008/2009 yang dilaksanakan oleh Yayasan Jantung Singapura (SHF) berkongsi pengalaman keluarganya ketika berhadapan dengan penyakit jantung dan angin ahmar, serta pergolakkan emosi dan fizikal beliau ketika berat badannya yang berlebihan, serta kejayaan beliau dalam mengukir namanya sebagai seorang pakar senaman dan pemakanan yang sentiasa menggalak gaya hidup sihat. Bagaimanakah gaya hidup anda sebelumnya? Ketika zaman persekolahan, saya tidak aktif dalam sukan. Selepas itu, sewaktu saya bekerja sebagai seorang setiausaha di Banque Nationale de Paris, kehidupan harian saya amat santai. Masa saya dihabiskan untuk bekerja di pejabat atau keluar bersama kawan-kawan untuk makan. Semenjak dahulu, saya memang suka makan. Oleh kerana gaya hidup saya yang kurang aktif, ditambah pula dengan tabiat yang kuat makan, berat badan saya bertambah. Apakah yang mengakibatkan anda bertukar kegaya hidup sihat? Kegemukkan mula menghantui fikiran dan fizikal ketika berat badan saya mencapai 80 kg. Dengan ketinggian yang hanya 1.55 meter, saya tergolong di dalam kategori gemok. Setiap kali melihat cermin, kemuraman menyelubungi saya. Perasaan malu untuk memilih dan mencuba pakaian walaupun bersaiz XXL, ketika membeli-belah, amat memilukan. Masalah bertambah apabila kedua lutut saya pula tidak dapat menampung berat badan yang berlebihan, sehinggakan saya terpaksa menjalani operasi untuk menggantikan lutut. Keyakinan diri mula merosot, sehingga saya sering berperap di rumah dan mula menjauhkan diri dari bergaul dengan orang ramai. Kerana terdesak, saya mula mengambil jalan mudah menurunkan berat badan secara mendadak. Saya mula mengambil ubat pelangsing dan mencuba diet fad. Akibatnya, saya menghadapi masalah kesihatan seperti sakit gastrik, lesu tidak berdaya, cepat marah dan mudah jatuh sakit. Diet fad pula menyebabkan kesan yoyo ke atas badan saya. Kandungan lemak di badan semakin bertambah dan protin pula berkurangan jika dibandingkan dengan keadaan sebelumnya,menyebabkan saya berasa semakin gemuk. Saya mula sedar bahawa selama ini, saya telah mengambil jalan yang salah. Akhirnya saya menemui penyelesaian bagi masalah berat badan saya. Saya mula menggamalkan tabiat makan yang seimbang dibantu dengan pelan senaman yang betul. Kematian bapa dan penderitaan keluarga saya meninggalkan kesan negatif pada perasaan saya. Tetapi, inilah yang membuat saya lebih berazam untuk mengamalkan gaya hidup yang sihat agar mengurangkan risiko saya ditimpa penyakit jantung dan strok. Apakah motivasi anda untuk meneruskan perjalanan ini? Di peringkat awal mengamalkan senaman dan makanan seimbang, saya menghadapi perbagai dugaan. Bukan senang. Dalam keadaan gemok dan juga berhadapan dengan masalah kesihatan yang lain, memang susah untuk mengikuti langkahlangkah aerobik yang mudah. Pernah suatu ketika di sesi senaman di gimnasium, seorang lelaki disitu menyuruh saya masukkan kemeja saya ke dalam seluar dengan nada memperli. Sebenarnya, saya memakai baju senaman yang ketat dan maksud di sebalik kata-katanya ialah agar saya mengempiskan perut saya yang besar ketika itu. Saya berasa sedih dan bertambah malu apabila semua orang ketawakan saya. Namun, kejadian ini membuatkan saya lebih berazam untuk membuktikan kebolehan saya mengecapi kejayaan. Ketekunan dan kegigihan ketika di sesi senaman, menghasilkan pencapaian yang begitu baik dari segi penurunan berat badan dan pemulihan kesihatan saya. Kesan positif ini menjadi dorongan kuat bagi saya. Berpegang pada kecekalan, saya berjaya mengharungi dan mengatasi cabaran ini. Justeru, dalam mencapai cita-cita, saya berjaya pula mempengaruhi rakan-rakan seperjuangan dan menjadi penggalak kuat gaya hidup sihat. Dengan pengalaman ini, saya begitu berminat menolong orang lain, lantas saya memutuskan untuk memperluas pengetahuan dalam bidang kesihatan dan nutrisi di luar negeri. Apabila pulang ke Singapura, saya menjalankan kelas, seminar, bengkel dan ceramah untuk menerap pengetahuan tentang kebaikan mengamalkan gaya hidup sihat secara berkesan melalui senaman dan pemakanan yang betul. Saya dapat memahami perasan mereka yang menghadapi masalah berat badan kerana saya pernah mengalami situasi yang sama. Kecekalan dan kegigihan mereka mengikuti pelan senaman dan pemakanan menjadi motivasi kepada saya untuk menjadi pendorong kepada lebih ramai orang, dan menularkan mesej tentang kepentingan mengamalkan gaya hidup sihat. Anda mempunyai sejarah penyakit jantung dalam keluarga anda. Siapa yang pernah menghadapi penyakit ini dan apakah kesan yang menimpa diri anda? Bapa saya meninggal dunia pada tahun 2006 akibat penyakit jantung. Abang saya, ketika berusia 49 tahun, meninggal dunia akibat angina ahmar pada tahun Ibu saya menggunakan kerusi roda akibat angina ahmar, yang kemungkinan besar disebabkan keadaannya yang gemuk. Kakak dan abang saya juga menghadapi gout dan hypertension. Kematian bapa dan penderitaan keluarga saya meninggalkan kesan negatif pada perasaan saya. Tetapi, inilah yang membuat saya lebih berazam untuk mengamalkan gaya hidup yang sihat agar mengurangkan risiko saya ditimpa penyakit jantung dan strok. Apakah yang memangkin anda untuk menjadi Duta Go Red for Women bagi SHF? Sebagai penggalak kuat gaya hidup sihat melalui senaman dan nutrisi, peluang mewakili dan menjadi duta sebuah badan yang ternama seperti SHF akan membuka laluan bagi saya membantu masyarakat agar pengalaman saya dapat dikongsi, dan citacita mulia untuk menjadi masyarakat sihat dapat dicapai. ~ Diterjemahkan oleh Rafidah Abdul Razak dan Iman Nabila Ashik Video keluaran khas oleh Dee Dee boleh didapati di SHF pada harga $15. DVD Dee Unravelled Fitness mengandungi pelan kesihatan menyeluruh termasuk cardiovascular, rutin kekuatan dan relaksi, dan juga video muzik SATU. Untuk mendapatkan video anda, sila hubungi /

11 Heart Disease & Stroke is the No.1 Killer of Women in Singapore and worldwide Singaporean women are more likely to die from heart disease and stroke than men Women are more likely to suffer from an unrecognised heart attack than men Women s risk of having a heart attack increases after menopause Women are less likely to seek corrective treatments for heart-related diseases compared to men Go Red For Women! Join the Fight Against Heart Disease! Visit Organiser Partners 2009 Sponsors