​Obesity Will Become The Leading Cause Of Risk For Heart Disease By 2050

Research by NUHCS Cardiologists Unveils Future Statistics on Obesity-Related Mortality

PULSE Issue 42 | February 2024

AMI, or more commonly known as heart attack, occurs when blood is unable to flow to a section of the heart muscle due to a blockage in a coronary artery. The blockage, usually in the form of a blood clot, deprives the heart muscle of oxygen and nutrients, causing severe damage to the affected heart tissue, and is often life-threatening. 

To project the prevalence of Type 2 Diabetes Mellitus (T2DM), hypertension, hyperlipidemia (or high cholesterol), obesity and smoking, among AMI-incident and AMI-related mortality for 2025 to 2050, Dr Nicholas Chew from the Cardiovascular-Metabolic Disease Translational Research Programme (CVMD TRP) at the Yong Loo Lin School of Medicine (NUS Medicine) and Department of Cardiology, NUHCS, led a study using data from the Singapore Myocardial Infarction Registry (SMIR) from January 2007 to December 2018, focusing on age group, gender and ethnicity. 

With the current sedentary lifestyle and silent obesity epidemic, obesity surpasses hypertension and hyperlipidemia by almost ten times (880%) as a risk factor. By 2050, out of every 100,000 who may have a heart attack, 3,764 will be overweight or obese, compared to 384 per 100,000 in 2025. This concerning increase will disproportionately affect overweight or obese females, with more than 13 times (1,204.7%) increase in heart attack cases by 2050. 

A huge increase in the incidence of heart attacks is also projected among Malays, with an expected twelve-fold (1,191.9%) increase per 100,000 population of obesity-related heart attacks, between 2025 and 2050. Obesity will contribute to an alarming four-fold (294.7%) increase in AMI-related deaths, while mortality rates associated with other risk factors like T2DM, hypertension, and smoking are expected to decline. The most substantial increase in AMI-related mortality will occur among Malays, with a five-fold (419.3%) rise, followed by a three and a half times (253.5%) increase among Indians.

Good News

"Research suggests that the projected increase in AMI cases can be halted with early detection and treatment of unrecognised diseases in high-risk groups including diabetes or high cholesterol, thus reducing metabolic risks. Implementing nationwide programmes focused on improving heart health can also potentially reduce obesity-related deaths. 

Dr Nicholas Chew emphasises on the need to steer away from a ‘one-size-fits-all’ approach to address the specific challenges faced by different groups at risk of the onset of a heart attack and mortality. For instance, younger and middle-aged individuals are more prone to obesity-related mortality, while older populations are more prone to increased metabolic diseases mortality due to hypertension and hyperlipidemia, thus, highlighting the importance of tailored interventions for different age groups. 

A/Prof Mark Chan, Deputy Executive Director, NUHCS, notes that while many European and U.S. studies have explored the cardiovascular disease burden in general populations, few studies have projected trends of metabolic diseases. These identified trends reflect larger, emerging trends worldwide, due to Singapore’s rapid socio-economic development and its multi-ethnic and ageing population. The population-based analysis in this study offers valuable insights that can potentially guide future global responses to cardiovascular-metabolic diseases."