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Risk of heart disease may increase with chronic illnesses such as high blood pressure and diabetes mellitus.

When it comes to heart disease, there are many risk factors involved. Some, such as family history, age and ethnicity, are beyond our control. Some require lifestyle changes. Yet other risk factors can be medically managed, as in the case of chronic diseases.

Dr Nadira Hamid, Associate Consultant, Department of Cardiology, National Heart Centre Singapore (NHCS), a member of the SingHealth group, explains how high blood pressure (hypertension), type 2 diabetes (diabetes mellitus) and high cholesterol are linked to heart disease, what puts you at risk of getting these conditions, and what you can do. 

Chronic illnesses that raise your heart disease risk

1. High blood pressure (hypertension)

High blood pressure (hypertension) refers to a blood pressure persistently above 140/90 mmHg. Known as a ‘silent killer’ as it’s a symptomless condition, hypertension is one of the major causes for coronary artery disease, stroke and bleeding in the brain.

If left untreated, high blood pressure may lead to long-term damage of organs such as the heart and blood vessels, leading to stroke, heart attack or renal failure. That’s why you should get your blood pressure checked at least once a year.

Causes of high blood pressure (hypertension)

  • Most of the time, the cause is unknown. However, blood pressure is likely to rise if:
  • Blood volume is increased by too much salt intake, leading to water retention.
  • Blood vessels become more rigid due to build-up of fatty deposits in blood vessel walls (atherosclerosis).

Risk factors

  • Age
  • Pre-existing medical conditions such as kidney disease or hormonal imbalance
  • Heavy alcohol consumption
  • Smoking
  • Obesity
  • High blood cholesterol levels

To control high blood pressure:

  • Stop smoking.
  • Take all your medications as prescribed.
  • Follow a low-salt diet to reduce the amount of fluid the heart has to pump.
  • Learn relaxation techniques that can help you manage stress.
  • Maintain a healthy weight.

2. Type 2 diabetes (diabetes mellitus)

Type 2 diabetes (diabetes mellitus) occurs when the body doesn’t make enough insulin or cannot properly use the insulin it produces. It’s the most common form of diabetes, with 90 to 95 per cent of all diabetes cases classified as type 2 diabetes. In Singapore, about 10 per cent of the population aged 18 to 69 has type 2 diabetes.

Studies have shown that having type 2 diabetes greatly increases your risk of heart disease.

Risk factors of type 2 diabetes

  • Excess body weight – The more overweight you are, the more insulin-resistant your body may become, causing glucose levels in your blood to rise.
  • Above the age of 45 – The risk of type 2 diabetes increases with age, especially after 45
  • Family history – If diabetes runs in your family, your risk of getting it is higher. However, a healthy diet and regular exercise can help mitigate this risk.

If these factors apply to you, you should pay special attention to the signs and symptoms of diabetes, which include:

  • Low energy
  • Increased thirst and need to urinate
  • Unexplained weight loss
  • Blurred vision
  • Constant hunger
  • Itchy skin or ‘pins and needles’ sensations in the limbs
  • Slow healing of wounds

To prevent type 2 diabetes:

  • Eat healthy – Choose foods low in fat and calories, and include more vegetables and whole grains in your diet.
  • Exercise regularly – Aim for 30 mins of moderate physical activity daily such as brisk walking, cycling or swimming. If you are unable to accommodate a long workout, spread it into smaller sessions throughout the day.
  • Maintain a healthy weight – Reduce your risk of diabetes by keeping a healthy weight through proper eating and regular exercise.

3. High blood cholesterol (hyperlipidaemia)

Like hypertension, high blood cholesterol (hyperlipidaemia) hardly presents any symptoms. The two main types of cholesterol are:

  • LDL (low density lipoprotein) – Commonly known as ‘bad’ cholesterol as it carries cholesterol to tissues, including the arteries.
  • HDL (high density lipoprotein) – Known as ‘good’ cholesterol as it takes cholesterol from the tissues to the liver, where it can be removed from the body.

When it comes to cholesterol, the key is to keep LDL cholesterol down while raising HDL cholesterol. Accumulation of too much ‘bad’ cholesterol in your blood can lead to a build-up of plaque in artery walls, causing a narrowing and hardening of blood vessels (atherosclerosis). This increases your likelihood of developing heart disease.

Risk factors of high blood cholesterol:

  • Poor diet – Consuming foods high in saturated fats, trans fats and cholesterol
  • Being overweight/obese
  • Sedentary lifestyle
  • Heredity – If your family members have high cholesterol, you may also have it

To lower your cholesterol:

  • Opt for ‘healthier’ fats such as mono-unsaturated fats (olive oil, canola oil, nuts like almonds and cashews, and avocados), polyunsaturated fats (vegetable oils like soybean oil, sunflower oil and corn oil), and omega-3 fats (salmon, sardines and mackerel).
  • Choose fish, skinless poultry and lean meat when choosing meat, and low-fat or fat-free milk products.
  • Consume more fibre-rich foods such as vegetables, fruits and whole grains.
  • Exercise regularly – Aim to have 30 mins of moderate physical activity daily such as brisk walking, cycling or swimming. If you are unable to accommodate a long workout, spread it into smaller sessions throughout the day or week.
  • Maintain a healthy weight
  • Quit smoking 
  • Limit alcohol intake to no more than 3 standard drinks for man and 2 standard drinks for women in a day.


Reproduced with permission from SingHealth’s HealthXChange, Singapore’s first interactive health and lifestyle resource portal. For more information, visit
Also read:

5 Ways to Reduce Risk of Heart Disease
High Blood Pressure: Causes & Risk Factors